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Mathematical Modeling of Outflow Facility Increase With Trabecular Meshwork Bypass and Schlemm Canal Dilation.

Publication ,  Journal Article
Yuan, F; Schieber, AT; Camras, LJ; Harasymowycz, PJ; Herndon, LW; Allingham, RR
Published in: J Glaucoma
April 2016

PURPOSE: To mathematically model the conventional aqueous humor outflow system with trabecular meshwork (TM) bypass and Schlemm canal (SC) dilation. METHODS: The SC was modeled as a rectangular channel with the TM modeled as a permeable membrane. The collector channels (CCs) were modeled as fluid sinks distributed along the outer wall of SC. Two different implants were investigated in this study. The Hydrus Microstent (scaffold) was modeled with a TM bypass and a dilated region in SC that was 7 or 15 mm long and approximately 5-fold larger than the normal height of SC (h0). The iStent trabecular microbypass was modeled with a similar structure except that the dilated region in SC was 1 mm long and 25% larger than h0. RESULTS: Creation of a TM bypass structure would increase the pressure in the surrounding regions inside the SC and make it close to the intraocular pressure. SC dilation would increase the pressure more uniformly in the dilated region. The pressure increase led to higher flow rates in SC and CCs, and subsequently increased outflow facility (C). If CCs were uniformly distributed, the increase in C was the smallest after implantation of 1 microbypass, compared with that after implantation of 2 microbypasses or 1 scaffold. If CCs were nonuniformly distributed, the magnitude of increase in C was sensitive to the location of implant, and the sensitivity was higher for the microbypass than the scaffold. CONCLUSION: The study showed that creation of TM bypass and SC dilation significantly increased outflow facility, and the amount of increase correlated with the length of dilated regions in SC.

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Published In

J Glaucoma

DOI

EISSN

1536-481X

Publication Date

April 2016

Volume

25

Issue

4

Start / End Page

355 / 364

Location

United States

Related Subject Headings

  • Trabecular Meshwork
  • Tonometry, Ocular
  • Ophthalmology & Optometry
  • Models, Theoretical
  • Limbus Corneae
  • Intraocular Pressure
  • Humans
  • Glaucoma Drainage Implants
  • Dilatation, Pathologic
  • Aqueous Humor
 

Citation

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Yuan, F., Schieber, A. T., Camras, L. J., Harasymowycz, P. J., Herndon, L. W., & Allingham, R. R. (2016). Mathematical Modeling of Outflow Facility Increase With Trabecular Meshwork Bypass and Schlemm Canal Dilation. J Glaucoma, 25(4), 355–364. https://doi.org/10.1097/IJG.0000000000000248
Yuan, Fan, Andrew T. Schieber, Lucinda J. Camras, Paul J. Harasymowycz, Leon W. Herndon, and R Rand Allingham. “Mathematical Modeling of Outflow Facility Increase With Trabecular Meshwork Bypass and Schlemm Canal Dilation.J Glaucoma 25, no. 4 (April 2016): 355–64. https://doi.org/10.1097/IJG.0000000000000248.
Yuan F, Schieber AT, Camras LJ, Harasymowycz PJ, Herndon LW, Allingham RR. Mathematical Modeling of Outflow Facility Increase With Trabecular Meshwork Bypass and Schlemm Canal Dilation. J Glaucoma. 2016 Apr;25(4):355–64.
Yuan, Fan, et al. “Mathematical Modeling of Outflow Facility Increase With Trabecular Meshwork Bypass and Schlemm Canal Dilation.J Glaucoma, vol. 25, no. 4, Apr. 2016, pp. 355–64. Pubmed, doi:10.1097/IJG.0000000000000248.
Yuan F, Schieber AT, Camras LJ, Harasymowycz PJ, Herndon LW, Allingham RR. Mathematical Modeling of Outflow Facility Increase With Trabecular Meshwork Bypass and Schlemm Canal Dilation. J Glaucoma. 2016 Apr;25(4):355–364.

Published In

J Glaucoma

DOI

EISSN

1536-481X

Publication Date

April 2016

Volume

25

Issue

4

Start / End Page

355 / 364

Location

United States

Related Subject Headings

  • Trabecular Meshwork
  • Tonometry, Ocular
  • Ophthalmology & Optometry
  • Models, Theoretical
  • Limbus Corneae
  • Intraocular Pressure
  • Humans
  • Glaucoma Drainage Implants
  • Dilatation, Pathologic
  • Aqueous Humor