Novel synthetic meshwork for glaucoma treatment. I. Design and preliminary in vitro and in vivo evaluation of various expanded poly(tetrafluoroethylene) materials.
A novel drainage implant for glaucoma filtering surgery (MESH) is proposed. After various expanded poly(tetrafluoroethylene) (e-PFTE) materials were evaluated, the feasibility and the short-term safety of the technique were assessed in this first pilot study in the rabbit. The porous structure and the in vitro resistance to aqueous flow of seven different e-PTFE membranes (5-80 microm average pore size) were compared. Eight Dutch pigmented rabbits were implanted with the T-shaped MESH implants made from either 20- or 50-microm average pore size e-PTFE membranes. Clinical examination, intraocular pressure (IOP) measurements, and histology analyses were performed over a period of 3 months. The contralateral nonoperated eyes served as controls. MESH implantation took less than 7 min. No postoperative hypotony, migration, or extrusion of the implant and no intraocular inflammation or infection occurred. A significant IOP reduction in the implanted eyes was obtained past postoperative day 21 with the 20-microm material implant. The drainage efficacy was correlated with the degree of colonization of the porous materials and the inner spacing of the implant as observed by histology. With a filtering patency 3 times longer than conventional trabeculectomy and laser sclerectomy, MESH surgery is a promising technique for glaucoma treatment. Further studies are underway to enhance the device efficacy and understand the mechanism of filtration.
Jallet
V
V
Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, University of Miami School of Medicine, 900 NW 17th Street, Miami, Florida 33136, USA.
Gautier
S E
SE
Parel
J M
JM
Matsui
T
T
Haefliger
I
I
Kondo
H
H
Kato
H
H
Savoldelli
M
M
Pouliquen
Y
Y
D000818:Animals; D001672:Biocompatible Materials / Q000009:adverse effects / Q000737:chemistry; D005901:Glaucoma / Q000601:surgery*; D020327:Glaucoma Drainage Implants; D006801:Humans; D011138:Polytetrafluoroethylene / Q000009:adverse effects / Q000737:chemistry; D011817:Rabbits
D001672:Biocompatible Materials; D011138:Polytetrafluoroethylene