Analytical model for managing hypotony after implantation surgery of a glaucoma drainage device

• Main Authors: Agujetas, R. (Author), Fernández-Vigo, J.I (Author), García-Feijóo, J. (Author), Kudiesh, B. (Author), Montanero, J.M (Author)
• Format: Article
• Language: English
• Published: Springer Science and Business Media Deutschland GmbH 2021
• Subjects: adverse device effect; adverse event; Analytical models; Anterior chamber; aqueous humor; Aqueous Humor; aqueous humor flow; Aqueous humor flow; Article; biological model; ciliary body; Cylindrical tubes; Filtering blebs; flow rate; Glaucom; glaucoma; Glaucoma drainage device; Glaucoma drainage devices; glaucoma drainage implant; Glaucoma Drainage Implants; glaucoma surgery; human; Humans; Hydraulic resistances; implantation; Intra ocular pressure; intraocular hypotension; intraocular pressure; Intraocular pressure; Intraocular Pressure; Models, Biological; Ocular Hypotension; Ophthalmology; pathophysiology; physiology; prosthesis implantation; Prosthesis Implantation; Schlemm canal; surgeon; Surgery; Surgical treatment; trabecular meshwork; Tube diameters; Tubes (components)
• Online Access: View Fulltext in Publisher

 The main aim of glaucoma treatment is to reduce the intraocular pressure (IOP). One of the most common surgical treatments of glaucoma is the implantation of a glaucoma drainage device to drain the aqueous humor from the anterior chamber to a filtration bleb, where the aqueous humor is absorbed. In some cases, the excess of drainage causes ocular hypotony, which constitutes a sight-threatening complication. To prevent hypotony after this intervention, surgeons frequently introduce a suture into the device tube, which increases the hydraulic resistance of the tube and, therefore, the IOP. This study aims to provide an analytical model to correct hypotony following implantation surgery of a glaucoma drainage device, which may help glaucoma surgeons decide on hypotony treatment. The results indicate that the IOP after implanting a cylindrical tube around 300 μm in diameter is essentially the same as that built up in the filtering bleb and can hardly be controlled by introducing a straight suture unless the suture diameter is slightly lower than that of the tube. On the contrary, when the tube diameter is smaller than, for example, 100 μm, significant reductions of the IOP can be obtained by introducing a thin suture into the tube. © 2021, The Author(s).