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Assessing flow control and biocompatibility of a novel glaucoma drainage device

Lee, Richard Men Ho; (2018) Assessing flow control and biocompatibility of a novel glaucoma drainage device. Doctoral thesis (Ph.D), UCL (University College London).

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Abstract

Glaucoma is a group of optic neuropathies that is the leading cause of irreversible visual impairment worldwide. Studies in the literature have demonstrated that reducing the intraocular pressure (IOP) to ten mmHg or less via medical, laser or surgical approaches can reduce the risk of glaucoma progression. Glaucoma drainage devices (GDDs) that shunt aqueous humour to the subconjunctival space suffer from complications including hypotony (<5 mmHg), require expertise to insert and are at risk of failure due to fibrous encapsulation around the device which prevents aqueous humour drainage (at a rate of 10% per year). There is therefore a need for a device that can control IOP adequately to reduce glaucoma progression, has a lower failure rate than conventional devices and is easy to insert even by novice surgeons. The aim of this body of work is to develop a novel GDD, the BioChannel® that may fulfil these criteria. This thesis encompasses work performed to assess in vitro protein adsorption and cell adhesion to 3D-printed and hydrogel materials that could potentially be used with our device versus materials used in existing ophthalmic devices. We assessed flow control approaches and mechanisms of outflow resistance that may affect the IOP control of our device using novel microfluidic testing methods. We compared our prototype device to a biocompatible silicone tube used in current GDDs in an in vivo rabbit study. We demonstrated no significant difference in IOP control or inflammatory response on histological analysis between materials assessed. Future developments will revolve around optimising our device design, assessing the biocompatibility response of our preclinical device in a long-term in vivo study before preparation to assess the device in a clinical trial in human subjects.

Type: Thesis (Doctoral)
Qualification: Ph.D
Title: Assessing flow control and biocompatibility of a novel glaucoma drainage device
Event: UCL (University College London)
Language: English
URI: http://discovery.ucl.ac.uk/id/eprint/10051042
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