DEVELOPMENT OF A NOVEL GLAUCOMA IMPLANT

青光眼是世界上致盲的主要原因。青光眼是一种复杂的疾病，有许多潜在的病因。目前，唯一有效的治疗方法是降低眼压（lOP）至临床安全范围。很大一部分青光眼患者需要手术干预来阻止视神经的进行性损伤。目前难治性青光眼的手术选择包括小梁切除术和青光眼引流植入物。虽然抗代谢物提高了小梁切除术的成功率，但它们的使用与不可预测的血流控制、低张力、伤口渗漏、囊膜纤维化和感染有关。青光眼管植入物越来越受欢迎，但目前所有商用设备都受到纤维化反应的困扰，最终限制了这些设备的流出设施并阻止了较低的lOP。此外，纤维囊增加了运动障碍和上睑下垂的风险，并最终限制了这些青光眼植入物的过滤寿命。试图改变对传统植入物的纤维化反应在很大程度上是不成功的。最近有尝试开发使用各种生物相容性膜的新一代青光眼植入物，但成功率有限。我们提出了一种独特的植入物设计，由生物相容性膜组成，在动物模型中表现出良好的流动和组织特性。我们建议将现有的植入物与膜结合以提高性能。一旦建成，该装置将在兔子模型系统中进行测试。在移植时，将进行流出阻力和组织学分析，以评估种植体的功能和组织反应。随着长期性能的提高，手术器械的使用可能会显著增加。开发一种安全有效的青光眼引流装置将大大提高我们减少这种常见疾病导致的失明的能力。

DESCRIPTION (provided by applicant) 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.