title: Novel synthetic meshwork for glaucoma treatment. I. Design and preliminary in vitro and in vivo evaluation of various expanded poly(tetrafluoroethylene) materials.
abstract: 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.
authors.affiliation: Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, University of Miami School of Medicine, 900 NW 17th Street, Miami, Florida 33136, USA.
authors.forename: V
authors.initials: V
authors.lastname: Jallet
authors.forename: S E
authors.initials: SE
authors.lastname: Gautier
authors.forename: J M
authors.initials: JM
authors.lastname: Parel
authors.forename: T
authors.initials: T
authors.lastname: Matsui
authors.forename: I
authors.initials: I
authors.lastname: Haefliger
authors.forename: H
authors.initials: H
authors.lastname: Kondo
authors.forename: H
authors.initials: H
authors.lastname: Kato
authors.forename: M
authors.initials: M
authors.lastname: Savoldelli
authors.forename: Y
authors.initials: Y
authors.lastname: Pouliquen
mesh_terms: 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
chemical_list: D001672:Biocompatible Materials; D011138:Polytetrafluoroethylene