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Fea AM, Ricardi F, Cariola R, Rossi A. Hydrus microstent for the treatment of primary open-angle glaucoma: overview of its safety and efficacy. Expert Rev Med Devices 2023; 20:1009-1025. [PMID: 37752854 DOI: 10.1080/17434440.2023.2259788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 09/13/2023] [Indexed: 09/28/2023]
Abstract
INTRODUCTION Minimally invasive glaucoma surgeries (MIGS) are now a consolidated reality in many surgical units. The Hydrus Microstent is one of several MIGS devices bypassing trabecular outflow and had excellent results over the years. This article aims to review the key features of the Hydrus Microstent in terms of design, efficacy, and safety. AREAS COVERED The present review analyses the main characteristics of the device by evaluating the technical and physical details of its functioning. The evidence that supports a clinical decision summarizes the most influential clinical trials and the most accurate systematic reviews. EXPERT OPINION The Hydrus device has been extensively studied regarding biocompatibility and outflow potential. The subsequent clinical studies have been well-built and proved that the device effectively reduces intraocular pressure (IOP) and the eyedrop load. The device covers almost a quarter of Schlemm's canal circumference, offering at least two advantages: cannulating the Schlemm's canal provides evidence that the device has been implanted correctly; covering a larger area potentially allows to target multiple collector channels or at least areas of active outflow. This scaffold may prove more effective in naïve patients or subjects who used antiglaucoma eyedrops for a limited period, as the prolonged use of hypotonic medications has been associated with the surgical failure of ab interno microhook trabeculotomy.
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Affiliation(s)
- Antonio M Fea
- Institute of Ophthalmology, Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Federico Ricardi
- Institute of Ophthalmology, Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Rossella Cariola
- Institute of Ophthalmology, Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Alessandro Rossi
- Institute of Ophthalmology, Department of Surgical Sciences, University of Turin, Turin, Italy
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Katz R, Sze C, Punyala A, Ahmed MA, Safadi A, Roizman S, Zisman A, Aharoni S, Baniel J, Chughtai B. Characterization of the histological response to the Butterfly Prostatic Retraction Device in patients with benign prostatic hyperplasia. World J Urol 2023; 41:1141-1146. [PMID: 36797501 DOI: 10.1007/s00345-023-04319-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 01/28/2023] [Indexed: 02/18/2023] Open
Abstract
PURPOSE The Butterfly Prostatic Retraction Device ("Butterfly") is a permanent nitinol implant for benign prostatic hyperplasia. This study examines the chronic response of prostate tissue to the Butterfly in histological specimens from patients in the Butterfly pilot clinical study. METHODS Retrospective qualitative and semi-quantitative review of histological specimens of seven (7) patients who participated in the Butterfly pilot clinical study. Patients had at least 1-month implantation with the Butterfly prior to implant removal and TURP. Tissue samples were graded by two pathologists. RESULTS Four out of six patients had IPSS decreased from baseline. All seven patients' samples had signs of chronic inflammation; one demonstrated acute inflammation and one demonstrated fibrosis. In three cases, intraglandular calcification was identified. There was no ischemic necrosis induced by the implant, and no encrustation, urethral edema, or cellular atypia was noted. CONCLUSION The Butterfly demonstrated an overall favorable safety profile in terms of tissue response. This study demonstrates that there is no significant tissue reaction in the prostatic urethra due to presence of Butterfly device.
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Affiliation(s)
- Ran Katz
- Ziv Medical Center, Safed, Israel
| | - Christina Sze
- Department of Urology, Weill Cornell Medicine/New York-Presbyterian Hospital, 525 E. 68Th Street, New York, NY, 10021, USA
| | - Ananth Punyala
- Department of Urology, Weill Cornell Medicine/New York-Presbyterian Hospital, 525 E. 68Th Street, New York, NY, 10021, USA
| | | | | | | | | | | | | | - Bilal Chughtai
- Department of Urology, Weill Cornell Medicine/New York-Presbyterian Hospital, 525 E. 68Th Street, New York, NY, 10021, USA.
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Samet S, Ong JA, Ahmed IIK. Hydrus microstent implantation for surgical management of glaucoma: a review of design, efficacy and safety. EYE AND VISION 2019; 6:32. [PMID: 31660323 PMCID: PMC6805473 DOI: 10.1186/s40662-019-0157-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2019] [Accepted: 09/23/2019] [Indexed: 11/30/2022]
Abstract
With the advent of microinvasive glaucoma surgery (MIGS), the spectrum of modalities available to manage patients with this chronic and heterogeneous condition has broadened. Despite its novelty however, there has been a rapid evolution in the development of a multitude of devices, each targeting a structure along the aqueous drainage pathway. A growing body of evidence has demonstrated IOP and medication burden reduction, and a more favorable safety profile with MIGS procedures in contrast to traditional incisional surgeries. Among the array of MIGS, the Hydrus® Microstent (Ivantis, Inc., Irvine, CA) is a recent FDA approved device, designed to bypass the trabecular meshwork and provide a scaffold for Schlemm’s canal. The objective of this article is to review the Hydrus from conception to clinical use, and present data on its efficacy and safety to date. The available literature has shown promise, however inherent to all novel devices, only long-term monitoring will ensure sustained IOP control and an acceptable safety profile. Surgical advancements in glaucoma have revolutionized the field, and continued research and development will establish these approaches in clinical treatment algorithms.
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Affiliation(s)
- Saba Samet
- 1Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON Canada.,2Prism Eye Institute, 2201 Bristol Circle, Suite 100, Oakville, ON L6H 0J8 Canada
| | - Jeb A Ong
- 1Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON Canada.,2Prism Eye Institute, 2201 Bristol Circle, Suite 100, Oakville, ON L6H 0J8 Canada
| | - Iqbal Ike K Ahmed
- 1Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON Canada.,2Prism Eye Institute, 2201 Bristol Circle, Suite 100, Oakville, ON L6H 0J8 Canada
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Zhang S, Zheng Y, Zhang L, Bi Y, Li J, Liu J, Yu Y, Guo H, Li Y. In vitro and in vivo corrosion and histocompatibility of pure Mg and a Mg-6Zn alloy as urinary implants in rat model. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2016; 68:414-422. [PMID: 27524036 DOI: 10.1016/j.msec.2016.06.017] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Revised: 05/25/2016] [Accepted: 06/05/2016] [Indexed: 11/29/2022]
Abstract
Pure Mg and a Mg-6wt.% Zn alloy were investigated as potential candidates for biodegradable implants for the urinary system. The in vitro corrosion behavior was studied by potentiodynamic polarization and immersion tests in simulated body fluid (SBF) at 37°C. The in vivo degradation and histocompatibility were examined through implantation into the bladders of Wistar rats. The alloying element Zn elevated the passivation potential and increased the cathodic current density. Both in vitro and in vivo degradation tests showed a faster corrosion rate for the Mg-6Zn alloy. Tissues stained with hematoxylin and eosin (HE) suggested that both pure Mg and Mg-6Zn alloy exhibited good histocompatibility in the bladder indwelling implantation and no differences between pure Mg and Mg-6Zn groups were found in bladder, liver and kidney tissues during the 2weeks implantation. Overall, this work presented instructive information on the degradation properties and histocompatibility of pure Mg and the Mg-6Zn alloy in the urinary system.
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Affiliation(s)
- Shiying Zhang
- Department of Urology, Air Force General Hospital, 30 Fucheng Road, Haidian District, Beijing 100142, China; Key Laboratory of Aerospace Advanced Materials and Performance (Beihang University), Ministry of Education, Beijing 100191, China
| | - Yang Zheng
- School of Materials Science and Engineering, Beihang University, Beijing 100191, China; Key Laboratory of Aerospace Advanced Materials and Performance (Beihang University), Ministry of Education, Beijing 100191, China
| | - Liming Zhang
- Department of Urology, Air Force General Hospital, 30 Fucheng Road, Haidian District, Beijing 100142, China
| | - Yanze Bi
- School of Materials Science and Engineering, Beihang University, Beijing 100191, China; Key Laboratory of Aerospace Advanced Materials and Performance (Beihang University), Ministry of Education, Beijing 100191, China
| | - Jianye Li
- Department of Urology, Air Force General Hospital, 30 Fucheng Road, Haidian District, Beijing 100142, China
| | - Jiao Liu
- School of Materials Science and Engineering, Beihang University, Beijing 100191, China; Key Laboratory of Aerospace Advanced Materials and Performance (Beihang University), Ministry of Education, Beijing 100191, China
| | - Youbin Yu
- Department of Urology, Air Force General Hospital, 30 Fucheng Road, Haidian District, Beijing 100142, China
| | - Heqing Guo
- Department of Urology, Air Force General Hospital, 30 Fucheng Road, Haidian District, Beijing 100142, China.
| | - Yan Li
- School of Materials Science and Engineering, Beihang University, Beijing 100191, China; Beijing Key Laboratory for Advanced Functional Materials and Thin Film Technology (Beihang University), Beijing 100191, China.
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Kabir G, Lizu A. Material selection for femoral component of total knee replacement integrating fuzzy AHP with PROMETHEE. JOURNAL OF INTELLIGENT & FUZZY SYSTEMS 2016. [DOI: 10.3233/ifs-162094] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Golam Kabir
- School of Engineering, University of British Columbia (UBC), BC, Canada
| | - Afruna Lizu
- School of Health and Exercise Sciences, University of British Columbia (UBC), BC, Canada
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Grierson I, Saheb H, Kahook MY, Johnstone MA, Ahmed IIK, Schieber AT, Toris CB. A Novel Schlemm’s Canal Scaffold. J Glaucoma 2015; 24:460-8. [DOI: 10.1097/ijg.0000000000000012] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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