Implante laminar de drenagem: estudo hidrodinâmico, biomicroscópico e tonométrico em coelhos.

• Ano de defesa: 2004
• Autor(a) principal: Sérgio Jacobovitz
• Tipo de documento: Tese
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de Minas Gerais; Brasil; MEDICINA - FACULDADE DE MEDICINA; Programa de Pós-Graduação em Oftalmologia; UFMG
• Palavras-chave em Português: Glaucoma; Implantes para glaucoma; Oftalmologia; Tratamento cirúrgico do glaucoma; Glaucoma/cirurgia; Implantes para Drenagem de Glaucoma
• Link de acesso: http://hdl.handle.net/1843/35161

The objective of this study was to create a laminar drainage implant (LDI) to reduce the intraocular pressure (IOP) and to evaluate its behavior in implanted rabbits, besides developing a method of gauging the IOP to study the hydrodynamic of the LDI. In the preliminary studies, LDI project was designed. In the first stage, 36 rabbits were divided in three groups: Group I (trabeculectomy), Group II (trabeculectomy+LDI) and Group III (LDI), which was studied during 41 days by an electronic aplanation tonometer and biomicroscopy. In the second stage, a method of gauging the IOP through digital acquisition of signs was developed and 27 rabbits was distributed in three groups: Group IV (trabeculectomy), Group V (trabeculectomy+LDI) and Group VI (LDI), the IOP was registered before and 4 days after the surgery. The parameters: basal IOP, derived dP/dTXP and the integral dPXdT of the curve PXT were studied. The first stage results showed uveitis, endoftalmitis and implant migration absence in all the implanted rabbits. The conjuntival blebs were more durable in the Group III when compared to the Group I for 2 consecutive days (p <0,05). The basal IOP fell from 12,53±3,74 to 9,58±4,63mmHg in the Group I; from 21,26±2,97 to 10,39±3,87mmHg in the Group II; and from 18,71±2,97 to 13,71±5,31mmHg in the Group III. The difference was statistically significant in the implanted groups. The second study through the derived curves dP/dTXP demonstrated an increase of the drainage in all the groups in the fourth day after surgery: from -0,0032±0,0048 to -0,035±0,025mmHg/s in the Group IV; from -0,0046±0,0014 to -0,026±0,022mmHg/s in the Group V; and from -0,0049±0,0027 to -0,029±0,033mmHg/s in the Group VI (p <0,05 in the 3 groups). The Group IV integral didn't demonstrate significant differences in the before/after surgery analysis. In the Group V, a statistically significant difference has been demonstrated in all the segments of the pre-surgical/ fourth day integral data (p <0,05). In the Group VI there have been difference (p <0,05) in all, except in the second segment of the integral analysis. An accurate method of registry the IOP has been developed. One experimental implant has been created for glaucoma treatment. Our surgery has shown to be safe and the study of its hydrodynamics revealed similar effectiveness in all groups. The surgery results in the implanted groups were more predictable than the control group.