A novel patient-oriented numerical procedure for glaucoma drainage devices

Int J Numer Method Biomed Eng. 2018 Dec;34(12):e3141. doi: 10.1002/cnm.3141. Epub 2018 Sep 19.

Abstract

The present work analyses the performance of four glaucoma drainage devices, by means of a novel patient-oriented numerical procedure. The procedure is based on the three-dimensional geometry reconstruction from the stacks of tomographic images of a human eye, at different angles, on meshing and on thermo-fluid dynamics modelling activities, carried out on the reconstructed computational domain. The current three-dimensional eye model considers anterior chamber (AC), trabecular meshwork, Schlemm's canal, and collector channels, making use of generalised porous medium approach for modelling ocular porous tissue and cavities. The intraocular pressure (IOP) management inside AC of human eye is analysed, by comparing the results obtained for four drainage devices implanted in a human eye for glaucoma treatment, ie, ExPRESS shunt, iStent inject, SOLX gold micro shunt, and the novel silicon shunt device. The numerical results allow predicting the effects of the installation of these implants on human eyes, in terms of IOP decrease, aqueous humour velocity, pressure, friction coefficient, and local Nusselt number, pointing out the clear distinction between pre-operative and post-operative eye conditions for different glaucoma surgical techniques.

Keywords: generalised porous medium model; glaucoma drainage devices; glaucoma surgery; human eye; numerical modelling; patient oriented.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aqueous Humor*
  • Glaucoma Drainage Implants*
  • Humans
  • Intraocular Pressure*
  • Precision Medicine*
  • Prosthesis Design*
  • Trabecular Meshwork* / pathology
  • Trabecular Meshwork* / physiopathology