Suprachoroidal drainage of aqueous humour with a novel implant: Suprajet

• Main Authors: Uzeyir Gunenc, Gul Arikan, Ferim Gunenc, Banu Lebe, Sitki Eren, Elvan Ocmen, Arif Taylan Ozturk
• Format: Article
• Language: English
• Published: Press of International Journal of Ophthalmology (IJO PRESS) 2017-10-01
• Series: Guoji Yanke Zazhi
• Subjects: glaucoma; shunt; suprachoroidal surgery
• Online Access: http://ies.ijo.cn/cn_publish/2017/10/201710002.pdf
• ISSN: 1672-5123; 1672-5123

AIM: To evaluate the efficacy and safety of a new implant, Suprajet(VSY Biotechnology, Istanbul, Turkey), which is developed for supraciliary and suprachoroidal drainage of aqueous humour.<p>METHODS: Five rabbits were included in the study. One Suprajet shunt was implanted in one eye of each rabbit. Implantation was performed by a superior clear corneal incision through the anterior chamber into the suprachoroidal space. Proximal end of the implant was placed in the iris root resting against the scleral spur, distal end was placed in the suprachoroidal space. Rabbits were followed for 4wk. Preoperative and postoperative intraocular pressure(IOP)levels were measured with Tonopen AVIA. At last follow-up visit animals were sacrificed and eyes were enucleated. Macroscopic and histopathologic evaluation of the eyes were made. <p>RESULTS: Mean preoperative IOP was 18.6±6.1 mmHg. Mean postoperative IOP was 8.4±1.1 mmHg, at one week. At the 2^nd week of the follow-up period one rabbit died. Thereafter, only 4 rabbits were followed. Mean postoperative IOP was 11.0±2.8 mmHg at the 2^nd week, 9.50±3.1 mmHg at the 3^rd week and 11.3 ±3.3 mmHg at 4^th week after the operation. When mean preoperative IOP was compared with the postoperative IOP values, only the IOP at the first week was found as significantly lower(<i>P</i>=0.042). There was no statistically significant difference between mean preoperative IOP level and mean IOP level at 2, 3 and 4wk postoperatively(<i>P</i>=0.66, <i>P</i>=0.66 and <i>P</i>=0.102, respectively). As an intraoperative complication, minimal hyphema was noted in three eyes during the surgery. However, the next day hyphema cleared completely. Macroscopic evaluation of the enucleated material showed that in one eye the distal end of the implant was in the vitreous instead of suprachoroidal space, in the other 3 eyes the distal end of the implant was noted in the suprachoroidal space. In all eyes, proximal end of the implant was localized in the anterior chamber angle. Histopathologic evaluation of the enucleated eyes showed deposition of irregular collagen bundles and fibroplasia including numerous fibroblastic and histiocytic cells around the implant.<p>CONCLUSION: This preliminary animal study showed that implantation of Suprajet in glaucoma is a promising procedure. Further studies are needed to evaluate its efficacy and safety profile.