Intraocular pressure control after implantation of experimental antiglaucoma shunt versus trabeculectomy

Glaucoma treatment includes various methods, such as eye drops, laser treatment, and surgery. The known complications of trabeculectomy have motivated the development of alternative filtering devices, including an antiglaucoma shunt with a valve.The research aims to assess the efficacy of the antiglaucoma shunt in rabbits with induced hypertension.

The preclinical study compared intraocular pressure (IOP) values in 42 rabbits' eyes with induced steroid-induced intraocular hypertension that underwent trabeculectomy (Group A, n=21) versus antiglaucoma shunt implantation (Group B, n=21). Statistical analysis used a linear mixed model, with model validation through residual diagnostics, Q-Q plots, and evaluation of random effects.

Both surgical methods produced a significant and sustained reduction in IOP compared with induced ocular hypertension values (average decrease ≈ of 6,5 mmHg per time unit, p < 0,001). Group A and B did not differ statistically in their ability to lower IOP at any period of examination (baseline: p=0.91; induced hypertension: p=0.92; 1 month postoperative: p=0.11; and 3 months postoperative: p=0.18). There was no systemic group bias, but random effects analysis indicated moderate inter-subject variability.

The results demonstrate that in a steroid-induced rabbit model of intraocular hypertension, both the new design shunt and conventional trabeculectomy offer efficient and sustained IOP reduction. Across all time points, the absence of significant differences between the groups indicates that the antiglaucoma shunt performs comparably to the established surgical technique.

The implantation of the antiglaucoma shunt with valve showed IOP-lowering efficacy comparable to that of traditional trabeculectomy, maintaining sustained pressure decrease over the 3-month follow-up. According to these findings, the antiglaucoma shunt may be a viable surgical alternative for glaucoma treatment, warranting further research through long-term animal studies and clinical trials. It offers new possibilities in glaucoma treatment, with a postoperative IOP decrease of 35% or more.