Rebalancing translaminar pressure difference: a novel glaucoma surgery—a pilot trial in non-human primates

AIM: To propose a novel glaucoma surgery for rebalancing translaminar pressure difference. METHODS: Three non-human primates with normal eyes and two with laser-induced glaucoma underwent the novel surgical procedure. Cannulation of the subarachnoid space was performed after completion of routine vi...

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Main Authors: Chen Xin, Qing Sang, Shen Wu, Rui-Qi Pang, Dan-Ting Lin, Huai-Zhou Wang, Ning Lu, Ning-Li Wang
Format: Article
Language:English
Published: Press of International Journal of Ophthalmology (IJO PRESS) 2025-09-01
Series:International Journal of Ophthalmology
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Online Access:http://ies.ijo.cn/en_publish/2025/9/20250902.pdf
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author Chen Xin
Qing Sang
Shen Wu
Rui-Qi Pang
Dan-Ting Lin
Huai-Zhou Wang
Ning Lu
Ning-Li Wang
author_facet Chen Xin
Qing Sang
Shen Wu
Rui-Qi Pang
Dan-Ting Lin
Huai-Zhou Wang
Ning Lu
Ning-Li Wang
author_sort Chen Xin
collection DOAJ
description AIM: To propose a novel glaucoma surgery for rebalancing translaminar pressure difference. METHODS: Three non-human primates with normal eyes and two with laser-induced glaucoma underwent the novel surgical procedure. Cannulation of the subarachnoid space was performed after completion of routine vitrectomy steps. An XEN 45 implant was inserted into the created puncture to communicate between the vitreous body and subarachnoid space. Intraocular pressure (IOP), fundus photography, and spectral-domain optical coherence tomography were assessed at baseline and regular intervals during follow-up. RESULTS: All operated eyes showed IOP reduction in the first postoperative month. Two (2/3) normal eyes and one (1/2) glaucomatous eye maintained lower IOP until 18mo after operation. The XEN 45 implant remained positioned through the lamina cribrosa in all normal eyes but was not detected in two glaucomatous eyes. Complications observed in this study included retinal vascular bleeding in 1/3 normal eyes and XEN implant dislocation in all 2 glaucomatous eyes. CONCLUSION: Subarachnoid space cannulation and mini-shunt implantation may contribute to IOP reduction, possibly by rebalancing translaminar pressure difference and enhancing aqueous humor drainage. The development of a suitable mini-shunt requires further investigation.
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issn 2222-3959
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language English
publishDate 2025-09-01
publisher Press of International Journal of Ophthalmology (IJO PRESS)
record_format Article
series International Journal of Ophthalmology
spelling doaj-art-3ba09d29606b4bb38bd8c29f1be38cde2025-08-22T06:07:08ZengPress of International Journal of Ophthalmology (IJO PRESS)International Journal of Ophthalmology2222-39592227-48982025-09-011891619162510.18240/ijo.2025.09.0220250902Rebalancing translaminar pressure difference: a novel glaucoma surgery—a pilot trial in non-human primatesChen Xin0Qing Sang1Shen Wu2Rui-Qi Pang3Dan-Ting Lin4Huai-Zhou Wang5Ning Lu6Ning-Li Wang7Ning-Li Wang. Beijing Tongren Hospital, 1 Dongjiaominxiang Street, Dongcheng District, Beijing 100730, China. wningli@vip.163.comBeijing Tongren Hospital, Capital Medical University, Beijing 100730, China; Beijing Tsinghua Changgung Hospital, Tsinghua University, Beijing 102218, ChinaBeijing Institution of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, ChinaBeijing Tongren Hospital, Capital Medical University, Beijing 100730, ChinaBeijing Tongren Hospital, Capital Medical University, Beijing 100730, ChinaBeijing Tongren Hospital, Capital Medical University, Beijing 100730, ChinaBeijing Tongren Hospital, Capital Medical University, Beijing 100730, ChinaBeijing Tongren Hospital, Capital Medical University, Beijing 100730, China; Beijing Institution of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, ChinaAIM: To propose a novel glaucoma surgery for rebalancing translaminar pressure difference. METHODS: Three non-human primates with normal eyes and two with laser-induced glaucoma underwent the novel surgical procedure. Cannulation of the subarachnoid space was performed after completion of routine vitrectomy steps. An XEN 45 implant was inserted into the created puncture to communicate between the vitreous body and subarachnoid space. Intraocular pressure (IOP), fundus photography, and spectral-domain optical coherence tomography were assessed at baseline and regular intervals during follow-up. RESULTS: All operated eyes showed IOP reduction in the first postoperative month. Two (2/3) normal eyes and one (1/2) glaucomatous eye maintained lower IOP until 18mo after operation. The XEN 45 implant remained positioned through the lamina cribrosa in all normal eyes but was not detected in two glaucomatous eyes. Complications observed in this study included retinal vascular bleeding in 1/3 normal eyes and XEN implant dislocation in all 2 glaucomatous eyes. CONCLUSION: Subarachnoid space cannulation and mini-shunt implantation may contribute to IOP reduction, possibly by rebalancing translaminar pressure difference and enhancing aqueous humor drainage. The development of a suitable mini-shunt requires further investigation.http://ies.ijo.cn/en_publish/2025/9/20250902.pdftranslaminar pressure differenceglaucoma surgerylamina cribrosaintraocular pressure
spellingShingle Chen Xin
Qing Sang
Shen Wu
Rui-Qi Pang
Dan-Ting Lin
Huai-Zhou Wang
Ning Lu
Ning-Li Wang
Rebalancing translaminar pressure difference: a novel glaucoma surgery—a pilot trial in non-human primates
International Journal of Ophthalmology
translaminar pressure difference
glaucoma surgery
lamina cribrosa
intraocular pressure
title Rebalancing translaminar pressure difference: a novel glaucoma surgery—a pilot trial in non-human primates
title_full Rebalancing translaminar pressure difference: a novel glaucoma surgery—a pilot trial in non-human primates
title_fullStr Rebalancing translaminar pressure difference: a novel glaucoma surgery—a pilot trial in non-human primates
title_full_unstemmed Rebalancing translaminar pressure difference: a novel glaucoma surgery—a pilot trial in non-human primates
title_short Rebalancing translaminar pressure difference: a novel glaucoma surgery—a pilot trial in non-human primates
title_sort rebalancing translaminar pressure difference a novel glaucoma surgery a pilot trial in non human primates
topic translaminar pressure difference
glaucoma surgery
lamina cribrosa
intraocular pressure
url http://ies.ijo.cn/en_publish/2025/9/20250902.pdf
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