Abstract
Purpose: :
To determine whether a new second-generation bypass stent can increase outflow facility in cultured human anterior segments.
Methods: :
Human anterior segments (n=5) were placed in perfusion organ culture. After stabilization in culture and establishment of a baseline pressure, the anterior segment was removed from culture and one or two stents were inserted into the trabecular meshwork from the posterior side within the nasal quadrant using a specially designed applicator. Following stent placement, anterior segments were returned to culture and perfused. Morphology of the trabecular meshwork and Schlemm’s canal were assessed by light and scanning electron microscopy.
Results: :
Insertion of one stent into the nasal quadrant of the trabecular meshwork increased outflow facility from 0.17 ± 0.04 to 0.48 ± 0.33 µL/min/mmHg (p=0.063, n=5). Addition of a second stent further increased outflow facility to 0.83 ± 0.59 µL/min/mmHg (n=2). Scanning electron microscopy showed the thorax of the stent securely inserted within the trabecular meshwork while the head of the stent was located within the lumen of Schlemm’s canal. Minimal endothelial disruption was observed on Schlemm’s canal outer wall.
Conclusions: :
Insertion of one or two stents into the trabecular meshwork increased outflow facility with minimal disruption of the outer wall cells that line Schlemm’s canal.
Keywords: outflow: trabecular meshwork • trabecular meshwork • intraocular pressure