A novel Schlemm's Canal scaffold increases outflow facility in a human anterior segment perfusion model.
PURPOSE: An intracanalicular scaffold (Hydrus microstent) designed to reduce intraocular pressure as a glaucoma treatment was tested in human anterior segments to determine changes in outflow facility (C). METHODS: Human eyes with no history of ocular disease or surgeries were perfused within 49 hours of death. The anterior segments were isolated and connected to a perfusion system. Flow rates were measured at pressures of 10, 20, 30, and 40 mm Hg. The scaffold was inserted into Schlemm's canal of the experimental eye, while a control eye underwent a sham procedure. Flow rate measurements were repeated at the four pressure levels. Individual C values were computed by dividing the flow rate by its corresponding pressure, and by averaging the four individual C measurements. The change in C between control and experimental eyes was assessed by the ratio of the baseline and second C measurement. In two eyes, the placement of the scaffold was evaluated histologically. RESULTS: After scaffold implantation in the experimental eyes, the average C increased significantly from baseline (n = 9, P < 0.05). Ratios of C at all pressure levels, except for 10 mm Hg, were significantly higher in experimental eyes (n = 9) than control eyes (P < 0.05, n = 7). Histologically, the scaffold dilated Schlemm's canal with no visible damage to the trabecular meshwork. CONCLUSIONS: The Hydrus Microstent provided an effective way to increase outflow facility in human eyes ex vivo.
Camras, LJ; Yuan, F; Fan, S; Samuelson, TW; Ahmed, IK; Schieber, AT; Toris, CB
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