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Biocompatibility response to modified Baerveldt glaucoma drains.

Publication ,  Journal Article
Jacob, JT; Burgoyne, CF; McKinnon, SJ; Tanji, TM; LaFleur, PK; Duzman, E
Published in: J Biomed Mater Res
1998

Glaucoma implants are designed to increase fluid outflow from the eye in order to decrease intraocular pressure and prevent damage to the optic nerve. The implant consists of a silicone tube that is inserted into the anterior chamber at one end and is attached at the other end to a silicone plate that is sutured to the outside of the globe beneath the conjunctiva. The glaucoma "implant" becomes a "drain" over the first 3 to 6 postoperative weeks as the silicone plate is enclosed by a fibrous capsule that allows a space to form into which fluid can drain and from which fluid can be absorbed by the surrounding tissues. Ideally, the size and thickness of the capsule (the filtering bleb) that surrounds the plate is such that the amount of fluid that passes through the capsule is identical to the amount of fluid produced by the eye at an intraocular pressure of 8 to 14 mmHg. The most common long-term complication of these implants is failure of the filtering bleb 2 to 4 years after surgery due to the formation of a thick fibrous capsule around the device. Micromovement of the smooth drainage plate against the scleral surface may be integral to the mechanism of glaucoma implant failure by stimulating low-level activation of the wound healing response, increased collagen scar formation, and increased fibrous capsule thickness. To test this hypothesis, we modified seven Baerveldt implants by adding porous cellular ingrowth material to the posterior surface of the drainage plate. Seven modified and five unmodified implants were placed in adult rabbit eyes. After 6 months, we found that the fibrous capsule around the modified implants was significantly thinner than the capsule surrounding the unmodified implants (p < 0.05), particularly on the surface between the porous ingrowth material and the sclera (p < 0.05). Although type I collagen predominated in the fibrous capsules around both types of implants, the amount of type III collagen in the capsules around the modified implants was significantly less than the amount around the unmodified implants (p < 0.05). We believe that these data suggest a reduction in the wound healing response to the modified implants, with greater stability of capsule thickness. Long-term studies are needed to verify that the stability of the capsules around the modified implants persists over a period of years, in which case this type of modification may prove useful in prolonging the functional life of these devices in the surgical treatment of glaucoma.

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Published In

J Biomed Mater Res

DOI

ISSN

0021-9304

Publication Date

1998

Volume

43

Issue

2

Start / End Page

99 / 107

Location

United States

Related Subject Headings

  • Wound Healing
  • Rabbits
  • Prostheses and Implants
  • Microscopy, Electron, Scanning
  • Glaucoma
  • Biomedical Engineering
  • Biocompatible Materials
  • Animals
  • 4016 Materials engineering
  • 4003 Biomedical engineering
 

Citation

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Jacob, J. T., Burgoyne, C. F., McKinnon, S. J., Tanji, T. M., LaFleur, P. K., & Duzman, E. (1998). Biocompatibility response to modified Baerveldt glaucoma drains. J Biomed Mater Res, 43(2), 99–107. https://doi.org/10.1002/(sici)1097-4636(199822)43:2<99::aid-jbm3>3.0.co;2-g
Jacob, J. T., C. F. Burgoyne, S. J. McKinnon, T. M. Tanji, P. K. LaFleur, and E. Duzman. “Biocompatibility response to modified Baerveldt glaucoma drains.J Biomed Mater Res 43, no. 2 (1998): 99–107. https://doi.org/10.1002/(sici)1097-4636(199822)43:2<99::aid-jbm3>3.0.co;2-g.
Jacob JT, Burgoyne CF, McKinnon SJ, Tanji TM, LaFleur PK, Duzman E. Biocompatibility response to modified Baerveldt glaucoma drains. J Biomed Mater Res. 1998;43(2):99–107.
Jacob, J. T., et al. “Biocompatibility response to modified Baerveldt glaucoma drains.J Biomed Mater Res, vol. 43, no. 2, 1998, pp. 99–107. Pubmed, doi:10.1002/(sici)1097-4636(199822)43:2<99::aid-jbm3>3.0.co;2-g.
Jacob JT, Burgoyne CF, McKinnon SJ, Tanji TM, LaFleur PK, Duzman E. Biocompatibility response to modified Baerveldt glaucoma drains. J Biomed Mater Res. 1998;43(2):99–107.

Published In

J Biomed Mater Res

DOI

ISSN

0021-9304

Publication Date

1998

Volume

43

Issue

2

Start / End Page

99 / 107

Location

United States

Related Subject Headings

  • Wound Healing
  • Rabbits
  • Prostheses and Implants
  • Microscopy, Electron, Scanning
  • Glaucoma
  • Biomedical Engineering
  • Biocompatible Materials
  • Animals
  • 4016 Materials engineering
  • 4003 Biomedical engineering