Week #2 - Brinkley Brooks

 This week consisted of brainstorming, researching, and developing needs statements and requirements for our project. I spent most of my time on working on deliverable 1 and 3, as well as researching different devices and varied resistance levels. I also was in communication with the client to ensure that we were meeting the standards that they desired. 


Brainstorming: 

Storm Strat:

During this brainstorm session, we came up with about 100 ideas of how we could fulfill the outcome of lowered IOP that our client wants to see. The top 2 ideas that we will be running with are: 

  1. Utilizing a magnetic field to orient the surface area of a valve, which would control the resistance and flow in the eye. 
  2. Finding a biocompatible material that over time starts to dissolve. This would make it so once the eye builds up the resistance on its' own, the valve would no longer be necessary. 
  3. Using the loss of elasticity to control the resistance over time in a valve. 



Needs Statement: 
The main needs that we found from our client are: 
  1. Device/method to lower IOP using varied resistance
  2. Tool for measuring the volume of an eye during bench top testing 
  3. Improvement upon current technology/methods, can not make surgery more complicated
The needs statement was found to be:
"A novel technique to maintain IOP, through varied resistance, for people with unhealthy IOP"


Research: 

SOLX Device:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4807951/
  • Gold shunt to help lower IOP
  • Different than other methods because it uses an alternate pathway from anterior chamber directly to suprachoroidal space
  • The success rates are 67% - 79%, which is comparable to Ahmed
    • Fibrosis is still a side effect/problem
https://entokey.com/suprachoroidal-shunt-solx-gold-shunt/
  • Gold is used because it is inert and does not heavily react with the body 
  • The bypass method makes it so no bleb formation is needed
  • Takes advantage of the pressure gradient between the anterior chamber and suprachoroidal space. 



Varied Resistance:

https://www.sciencedirect.com/science/article/abs/pii/S016164209899042X

  • There was a study done to test if Ahmed varied the resistance depending on the flow
  • It was calculated by the change in pressure by the change in flow
  • The results showed that it did regulate pressure in a desired range through varying resistance
  • It is the only device currently to do this
https://iovs.arvojournals.org/article.aspx?articleid=2390135
  • Fibrosis increases resistance of outflow 
  • A test was done to see if a porous polymer coating would help alleviate fibrosis
  • An Ahmed valve was placed into an eye, and then an Ahmed valve with a coasting was placed into the eye to test this theory
  • From the results it can be noted that the material had a significant impact of reducing the resistance
Eye Anatomy and Other Devices:
https://ascpt.onlinelibrary.wiley.com/doi/pdf/10.1111/cts.12660
  • MIGS: minimally invasive glaucoma surgery 
  • MIGS devices outflow to the Schlemm's canal, superchoroidal space, or subconjuctive space
  • Material: biocompatible
  • Geometry: if tube shaped, are inserted with a needle tract, if not they may need an inserter device
  • 10-10-10 rule: 10 mmHg, last 10 years, 10 min procedure
Magnetic Device:
  • AGDD: adjustable glaucoma drainage device
  • Has an external control unit based on a compassions and magnet, which adjusts the surface area of the device depending on pressure level
  • Externally regulated 
  • Creates a bleb like the Ahmed valve







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