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

Nicol Basson*, Chao-Hong Surachai Peng, Patrick Geoghegan, Tshilidzi van der Lecq, David Steven, Susan Williams, An Eng Lim, Wei Hua Ho*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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.
Original languageEnglish
Article number3777
Number of pages8
JournalScientific Reports
Volume14
Early online date15 Feb 2024
DOIs
Publication statusPublished - 15 Feb 2024

Bibliographical note

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/.

Data Access Statement

The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.

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

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