Development of A Novel Glaucoma Implant

Ahmed, Abdul

Abstract

Glaucoma is the leading cause of blindness in the world. Glaucoma is a complex disease with many underlying etiologies. Currently, the only effective treatment is reducing intraocular pressure (lOP) to a clinically safe range. A significant portion of individuals with glaucoma will require surgical intervention to stop progressive optic nerve damage. Current surgical options for refractory glaucoma include trabeculectomy and the use of glaucoma drainage implants. Although antimetabolites have improved success rates for trabeculectomy, their use is associated with unpredictable control of flow, hypotony, wound leaks, capsular fibrosis and infection. Glaucoma tube implants have been gaining popularity, but all current commercially available devices are plagued with a fibrotic response that ultimately limits the outflow facility of these devices and prevents lower lOP. In addition, the fibrous capsule increases the risk of motility disturbances and ptosis and ultimately limits the filtration life of these glaucoma implants. Attempts to modify the fibrotic response to conventional implants have largely been unsuccessful. There have been recent attempts to develop newer generation glaucoma implants using various biocompatible membranes with limited success. We propose a unique implant design consisting of a biocompatible membrane that demonstrates favorable flow and tissue characteristics in an animal model. We propose to integrate an existing implant with the membrane to improve performance. Once constructed, the device will be tested in a rabbit model system. At the time of explant, outflow resistance and histological analysis will be performed to evaluate the function and tissue response of the implant. With improved long-term performance, use of surgical devices would likely increase significantly. Development of a safe and effective glaucoma drainage device will greatly improve our ability to reduce blindness from this common disorder.