Numerical model to predict and compare the hypotensive efficacy and safety of minimally invasive glaucoma surgery devices
To predict and compare the hypotensive efficacy of three minimally-invasive glaucoma surgery (MIGS) implants through a numerical model. Post-implant hypotensive efficacy was evaluated by using a numerical model and a computational fluid dynamics simulation. Three different devices were compared: the...
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| creator | Kudsieh, Bachar Fernández-Vigo, Jose Ignacio Agujetas, Rafael Montanero, Jose María Ruiz-Moreno, Jose María Fernández-Vigo, Jose Ángel García-Feijóo, Julián |
| description | To predict and compare the hypotensive efficacy of three minimally-invasive glaucoma surgery (MIGS) implants through a numerical model. 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 [mu]m), the XEN 63 stent (63 [mu]m) and the PreserFlo microshunt (70 [mu]m). 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. 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 ( |
| doi_str_mv | 10.1371/journal.pone.0239324 |
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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 [mu]m), the XEN 63 stent (63 [mu]m) and the PreserFlo microshunt (70 [mu]m). 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. 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). 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.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0239324</identifier><identifier>PMID: 32991588</identifier><language>eng</language><publisher>San Francisco: Public Library of Science</publisher><subject>Anterior chamber ; Biology and Life Sciences ; Care and treatment ; Comparative analysis ; Computational fluid dynamics ; Computer applications ; Computer simulation ; Engineering and Technology ; Equipment and supplies ; Eye surgery ; Fluid dynamics ; Glaucoma ; Hospitals ; Hydrodynamics ; Implants ; Intraocular pressure ; Iris ; Mathematical models ; Medical research ; Medicine and Health Sciences ; Minimally invasive surgery ; Numerical methods ; Numerical models ; Numerical prediction ; Ophthalmic equipment ; Permeability ; Physical Sciences ; Pressure ; Simulation ; Software ; Stents ; Surgery ; Surgical implants ; Transplants & implants</subject><ispartof>PloS one, 2020-09, Vol.15 (9), p.e0239324-e0239324</ispartof><rights>COPYRIGHT 2020 Public Library of Science</rights><rights>2020 Kudsieh et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. 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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 [mu]m), the XEN 63 stent (63 [mu]m) and the PreserFlo microshunt (70 [mu]m). 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. 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). 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.</description><subject>Anterior chamber</subject><subject>Biology and Life Sciences</subject><subject>Care and treatment</subject><subject>Comparative analysis</subject><subject>Computational fluid dynamics</subject><subject>Computer applications</subject><subject>Computer simulation</subject><subject>Engineering and Technology</subject><subject>Equipment and supplies</subject><subject>Eye surgery</subject><subject>Fluid dynamics</subject><subject>Glaucoma</subject><subject>Hospitals</subject><subject>Hydrodynamics</subject><subject>Implants</subject><subject>Intraocular pressure</subject><subject>Iris</subject><subject>Mathematical models</subject><subject>Medical research</subject><subject>Medicine and Health Sciences</subject><subject>Minimally invasive surgery</subject><subject>Numerical methods</subject><subject>Numerical models</subject><subject>Numerical prediction</subject><subject>Ophthalmic 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Ahmed</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Numerical model to predict and compare the hypotensive efficacy and safety of minimally invasive glaucoma surgery devices</atitle><jtitle>PloS one</jtitle><date>2020-09-29</date><risdate>2020</risdate><volume>15</volume><issue>9</issue><spage>e0239324</spage><epage>e0239324</epage><pages>e0239324-e0239324</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>To predict and compare the hypotensive efficacy of three minimally-invasive glaucoma surgery (MIGS) implants through a numerical model. 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 [mu]m), the XEN 63 stent (63 [mu]m) and the PreserFlo microshunt (70 [mu]m). 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. 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). 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.</abstract><cop>San Francisco</cop><pub>Public Library of Science</pub><pmid>32991588</pmid><doi>10.1371/journal.pone.0239324</doi><tpages>e0239324</tpages><orcidid>https://orcid.org/0000-0002-2600-8233</orcidid><orcidid>https://orcid.org/0000-0002-7772-5718</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Anterior chamber Biology and Life Sciences Care and treatment Comparative analysis Computational fluid dynamics Computer applications Computer simulation Engineering and Technology Equipment and supplies Eye surgery Fluid dynamics Glaucoma Hospitals Hydrodynamics Implants Intraocular pressure Iris Mathematical models Medical research Medicine and Health Sciences Minimally invasive surgery Numerical methods Numerical models Numerical prediction Ophthalmic equipment Permeability Physical Sciences Pressure Simulation Software Stents Surgery Surgical implants Transplants & implants |
| title | Numerical model to predict and compare the hypotensive efficacy and safety of minimally invasive glaucoma surgery devices |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-19T12%3A52%3A07IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Numerical%20model%20to%20predict%20and%20compare%20the%20hypotensive%20efficacy%20and%20safety%20of%20minimally%20invasive%20glaucoma%20surgery%20devices&rft.jtitle=PloS%20one&rft.au=Kudsieh,%20Bachar&rft.date=2020-09-29&rft.volume=15&rft.issue=9&rft.spage=e0239324&rft.epage=e0239324&rft.pages=e0239324-e0239324&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0239324&rft_dat=%3Cgale_plos_%3EA636883596%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2447247254&rft_id=info:pmid/32991588&rft_galeid=A636883596&rft_doaj_id=oai_doaj_org_article_71ea761032ef4b908cde2bee61bbedef&rfr_iscdi=true |