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Numerical model to predict and compare the hypotensive efficacy and safety of minimally invasive glaucoma surgery devices
PURPOSE: To predict and compare the hypotensive efficacy of three minimally-invasive glaucoma surgery (MIGS) implants through a numerical model. METHODS: Post-implant hypotensive efficacy was evaluated by using a numerical model and a computational fluid dynamics simulation. Three different devices...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7523982/ https://www.ncbi.nlm.nih.gov/pubmed/32991588 http://dx.doi.org/10.1371/journal.pone.0239324 |
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author | Kudsieh, Bachar Fernández-Vigo, Jose Ignacio Agujetas, Rafael Montanero, Jose María Ruiz-Moreno, Jose María Fernández-Vigo, Jose Ángel García-Feijóo, Julián |
author_facet | Kudsieh, Bachar Fernández-Vigo, Jose Ignacio Agujetas, Rafael Montanero, Jose María Ruiz-Moreno, Jose María Fernández-Vigo, Jose Ángel García-Feijóo, Julián |
author_sort | Kudsieh, Bachar |
collection | PubMed |
description | PURPOSE: To predict and compare the hypotensive efficacy of three minimally-invasive glaucoma surgery (MIGS) implants through a numerical model. METHODS: Post-implant hypotensive efficacy was evaluated by using a numerical model and a computational fluid dynamics simulation. Three different devices were compared: the XEN 45 stent (tube diameter, 45 μm), the XEN 63 stent (63 μm) and the PreserFlo microshunt (70 μm). The influence of the filtration bleb pressure (Bp) and tube diameter, length, and position within the anterior chamber (AC) on intraocular pressure (IOP) were evaluated. RESULTS: Using baseline IOPs of 25, 30 and 50 mmHg, respectively, the corresponding computed post-implant IOPs for each device were as follows: XEN 45: 17 mmHg (29% decrease), 19 mmHg (45%) and 20 mmHg (59%) respectively; XEN 63: 13 mmHg (48%), 13 mmHg (62%), and 13 mmHg (73%); PreserFlo: 12 mmHg (59%), 13 mmHg (73%) and 13 mmHg (73%). At a baseline IOP of 35 mmHg with an increase in the outflow resistance within the Bp from 5 to 17 mmHg, the hypotensive efficacy for each device was reduced as follows: XEN45: 54% to 37%; XEN 63: 74% to 46%; and PreserFlo: 75% to 47%. The length and the position of the tube in the AC had only a minimal (non-significant) effect on IOP (<0.1 mmHg). CONCLUSIONS: This hydrodynamic/numerical model showed that implant diameter and bleb pressure are the two most pertinent determinants of hypotensive efficacy. In distinction, tube length and position in the AC do not significantly influence IOP. |
format | Online Article Text |
id | pubmed-7523982 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-75239822020-10-06 Numerical model to predict and compare the hypotensive efficacy and safety of minimally invasive glaucoma surgery devices Kudsieh, Bachar Fernández-Vigo, Jose Ignacio Agujetas, Rafael Montanero, Jose María Ruiz-Moreno, Jose María Fernández-Vigo, Jose Ángel García-Feijóo, Julián PLoS One Research Article PURPOSE: To predict and compare the hypotensive efficacy of three minimally-invasive glaucoma surgery (MIGS) implants through a numerical model. METHODS: Post-implant hypotensive efficacy was evaluated by using a numerical model and a computational fluid dynamics simulation. Three different devices were compared: the XEN 45 stent (tube diameter, 45 μm), the XEN 63 stent (63 μm) and the PreserFlo microshunt (70 μm). The influence of the filtration bleb pressure (Bp) and tube diameter, length, and position within the anterior chamber (AC) on intraocular pressure (IOP) were evaluated. RESULTS: Using baseline IOPs of 25, 30 and 50 mmHg, respectively, the corresponding computed post-implant IOPs for each device were as follows: XEN 45: 17 mmHg (29% decrease), 19 mmHg (45%) and 20 mmHg (59%) respectively; XEN 63: 13 mmHg (48%), 13 mmHg (62%), and 13 mmHg (73%); PreserFlo: 12 mmHg (59%), 13 mmHg (73%) and 13 mmHg (73%). At a baseline IOP of 35 mmHg with an increase in the outflow resistance within the Bp from 5 to 17 mmHg, the hypotensive efficacy for each device was reduced as follows: XEN45: 54% to 37%; XEN 63: 74% to 46%; and PreserFlo: 75% to 47%. The length and the position of the tube in the AC had only a minimal (non-significant) effect on IOP (<0.1 mmHg). CONCLUSIONS: This hydrodynamic/numerical model showed that implant diameter and bleb pressure are the two most pertinent determinants of hypotensive efficacy. In distinction, tube length and position in the AC do not significantly influence IOP. Public Library of Science 2020-09-29 /pmc/articles/PMC7523982/ /pubmed/32991588 http://dx.doi.org/10.1371/journal.pone.0239324 Text en © 2020 Kudsieh et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Kudsieh, Bachar Fernández-Vigo, Jose Ignacio Agujetas, Rafael Montanero, Jose María Ruiz-Moreno, Jose María Fernández-Vigo, Jose Ángel García-Feijóo, Julián Numerical model to predict and compare the hypotensive efficacy and safety of minimally invasive glaucoma surgery devices |
title | Numerical model to predict and compare the hypotensive efficacy and safety of minimally invasive glaucoma surgery devices |
title_full | Numerical model to predict and compare the hypotensive efficacy and safety of minimally invasive glaucoma surgery devices |
title_fullStr | Numerical model to predict and compare the hypotensive efficacy and safety of minimally invasive glaucoma surgery devices |
title_full_unstemmed | Numerical model to predict and compare the hypotensive efficacy and safety of minimally invasive glaucoma surgery devices |
title_short | Numerical model to predict and compare the hypotensive efficacy and safety of minimally invasive glaucoma surgery devices |
title_sort | numerical model to predict and compare the hypotensive efficacy and safety of minimally invasive glaucoma surgery devices |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7523982/ https://www.ncbi.nlm.nih.gov/pubmed/32991588 http://dx.doi.org/10.1371/journal.pone.0239324 |
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