A computational fluid dynamics investigation of endothelial cell damage from glaucoma drainage devices

Abstract

Glaucoma drainage devices (GDDs) are prosthetic-treatment devices for treating primary open-angle glaucoma. Despite their effectiveness in reducing intraocular pressures (IOP), endothelial cell damage (ECD) is a commonly known side-effect. There have been different hypotheses regarding the reasons for ECD with one being an induced increase in shear on the corneal wall. A computational fluid dynamics (CFD) model was used to investigate this hypothesis in silico. The Ahmed Glaucoma Valve (AGV) was selected as the subject of this study using an idealised 3D model of the anterior chamber with insertion angles and positions that are commonly used in clinical practice. It was found that a tube-cornea distance of 1.27 mm or greater does not result in a wall shear stress (WSS) above the limit where ECD could occur. Similarly, a tube-cornea angle of 45° or more was shown to be preferable. It was also found that the ECD region has an irregular shape, and the aqueous humour flow fluctuates at certain insertion angles and positions. This study shows that pathological amounts of WSS may occur as a result of certain GDD placements. Hence, it is imperative to consider the associated fluid force interactions when performing the GDD insertion procedure.

Publication DOI: https://doi.org/10.1038/s41598-023-50491-9
Divisions: College of Engineering & Physical Sciences > School of Engineering and Technology > Mechanical, Biomedical & Design
Additional Information: Copyright © The Author(s) 2024. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit https://creativecommons.org/licenses/by/4. 0/.
Uncontrolled Keywords: Endothelial Cells,Follow-Up Studies,Glaucoma Drainage Implants/adverse effects,Glaucoma, Open-Angle/surgery,Glaucoma/surgery,Humans,Hydrodynamics,Intraocular Pressure,Prosthesis Implantation,Retrospective Studies,Treatment Outcome
Publication ISSN: 2045-2322
Data Access Statement: The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.
Last Modified: 11 Jun 2024 07:35
Date Deposited: 16 Feb 2024 13:10
Full Text Link:
Related URLs: https://www.nat ... 598-023-50491-9 (Publisher URL)
http://www.scop ... tnerID=8YFLogxK (Scopus URL)
PURE Output Type: Article
Published Date: 2024-12
Published Online Date: 2024-02-15
Accepted Date: 2023-12-20
Authors: Basson, Nicol
Surachai Peng, Chao-Hong
Geoghegan, Patrick (ORCID Profile 0000-0003-1224-0477)
van der Lecq, Tshilidzi
Steven, David
Williams, Susan
Lim, An Eng
Ho, Wei Hua

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