title: Preclinical investigation of ab interno trabeculectomy using a novel dual-blade device.
abstract: OBJECTIVE
  To evaluate the effects of a novel ab interno trabeculectomy device on human trabecular meshwork (TM).
  
  
  METHODS
  Laboratory evaluation.
  
  
  METHODS
  The TM from human cadaveric corneal rim tissue was incised using 3 instruments: (1) novel dual-blade device; (2) microvitreoretinal (MVR) blade; and (3) Trabectome. Tissue samples underwent histologic processing and comparative analyses. Subsequently, human eye perfusion studies were performed to evaluate intraocular pressure (IOP)-lowering effects of each device. Main outcome measures were degree of TM removal by histology and IOP in a perfusion model.
  
  
  RESULTS
  The MVR blade exhibited minimal removal of TM and obvious injury to the adjacent sclera. The Trabectome removed a large portion of the central TM, but leaflets of residual tissue remained and thermal injury was noted in all samples. The dual-blade device achieved a more complete removal of TM without injury to surrounding tissues. All devices resulted in statistically significant lowering of IOP during perfusion model studies. MVR blade treatment across 170.0 ± 14.1 degrees of TM resulted in a decrease of IOP from 18.5 ± 1.9 mm Hg to 12.8 ± 2.2 mm Hg (P < .01). Trabectome treatment across 117.5 ± 12.6 degrees resulted in a decrease of IOP from 18.8 ± 1.7 mm Hg to 11.3 ± 1.0 mm Hg (P < .01). Dual-blade device treatment across 157.5 ± 26.3 degrees resulted in a decrease of IOP from 18.3 ± 3.0 mm Hg to 11.0 ± 2.2 mm Hg (P < .01).
  
  
  CONCLUSIONS
  The novel dual-blade device demonstrated a more complete removal of TM without residual TM leaflets or damage to surrounding tissues and significantly reduced IOP in a human eye perfusion model.
authors.affiliation: Department of Ophthalmology, University of Colorado School of Medicine, Aurora, CO 80045, USA.
authors.forename: Leonard K
authors.initials: LK
authors.lastname: Seibold
authors.forename: Jeffrey R
authors.initials: JR
authors.lastname: Soohoo
authors.forename: David A
authors.initials: DA
authors.lastname: Ammar
authors.forename: Malik Y
authors.initials: MY
authors.lastname: Kahook
mesh_terms: D006801:Humans; D007429:Intraocular Pressure; D014019:Tissue Donors; D014129:Trabecular Meshwork / Q000601:surgery*; D014130:Trabeculectomy / Q000295:instrumentation*