Second-generation trabecular meshwork bypass stent (iStent inject) increases outflow facility in cultured human...

Area of Science:

• Ophthalmology
• Medical Devices
• Glaucoma Research

Background:

• Glaucoma management often involves lowering intraocular pressure (IOP).
• Trabecular meshwork (TM) bypass surgery offers a minimally invasive approach to enhance aqueous humor outflow.
• Second-generation devices aim to improve upon existing TM bypass stent technologies.

Purpose of the Study:

• To evaluate the impact of the second-generation iStent inject on outflow facility.
• To assess the efficacy of the iStent inject in cultured human anterior segments.

Main Methods:

• Prospective laboratory study using human donor eyes (n=7).
• Human anterior segments were cultured and perfused.
• One or two iStent inject stents were implanted into the TM.
• Outflow facility was measured, and morphology was assessed via SEM and 3D micro-CT.

Main Results:

• Single iStent inject implantation increased outflow facility from 0.16 to 0.38 μL/min/mm Hg (P < .03) and reduced IOP.
• A second iStent inject further increased outflow facility to 0.78 μL/min/mm Hg.
• SEM confirmed stent placement and revealed SC dilation and some cell disruption.

Conclusions:

• The iStent inject effectively increases outflow facility in human anterior segment cultures.
• This second-generation TM bypass stent is a promising device for IOP reduction in glaucoma patients.