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I INTRODUCTION
Huge number of people around the globe is affected by
permanent vision loss associated to glaucoma. There are very
less signs or symptoms till vision loss become severe. The
cause of the disease is not clearly known. The cure dose not
exists as of now. Glaucoma is characterized by pathological
changes in the optic disc and nerve fibre layer of retina.
Elevated IOP> 22mmHg (Intraocular Pressure) is known to
be responsible for slowly killing the ganglion cell axons that
comprise the optic nerve and is strongly implicated in the
pathogenesis of glaucoma. Reduction of intraocular pressure
reduces the rate of disease progress.
Glaucoma is an optic nerve disease resulting in loss of vision.
It is often associated with increased pressure of fluid inside
the eye. The types of glaucoma are: Open-angle glaucoma,
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International Journal of Engineering Trends and Technology (IJETT) Volume 7 Number 3- Jan 2014
condition is treated with a pharmacologic known as betablockers or adrenergic agnostics which are used to clear
blockages by regulating fluid production, inlet and exit
pressures to maintain an optimal IOP level. IOP is prone to
fluctuations and has been recorded to vary during different
times of the day. When chemicals fail to bring down IOP,
treatment is then focused on surgical removal and correction
of the structures blocking fluid drainage.
Apart from raised IOP, patients with glaucoma have been
observed to have an increased resistance to outflow of the
aqueous humor which is also expressed as facility of outflow
and is an important blockage related parameter denoted by
the symbol Cf.
Glaucoma management options include medical therapy,
laser surgery, incisional surgery and glaucoma drainage
devices (GDD). Medical therapy lowers IOP by improving
the outflow of aqueous humor (AH) or to reduce its
production. Some surgical techniques attempt to stimulate
AH outflow, however, the primary surgical strategy is to
manage glaucoma by lowering the patients IOP through
removal of excess AH. Regardless of the technique that is
employed, accurate real-time measurements of IOP and the
ability to restore normal levels are critical in the treatment of
this disease. We now see the various ways of treatment of
glaucoma using MEMS.
II TREATMENT OF GLAUCOMA
The doctors treating glaucoma target controlling IOP rise and
maintenance of IOP within 12-15 mmHg as a means of
achieving proper flow regulation .IOP is measured externally
on a monthly basis using a tonometer in a clinic. The
condition is treated with a pharmacologic known as betablockers or adrenergic agnostics which are used to clear
blockages by regulating fluid production, inlet and exit
pressures to maintain an optimal IOP level. IOP is prone to
fluctuations and has been recorded to vary during different
times of the day. When chemicals fail to bring down IOP,
treatment is then focused on surgical removal and correction
of the structures blocking fluid drainage. Apart from raised
IOP, patients with glaucoma have been observed to have an
increased resistance to outflow of the aqueous humor which
is also expressed as facility of outflow and is an important
blockage related parameter denoted by the symbol Cf.
Glaucoma management options include medical therapy,
laser surgery, incisional surgery and glaucoma drainage
devices(GDD). Medical therapy lowers IOP by improving
the outflow of aqueous humor (AH) or to reduce its
production. Some surgical techniques attempt to stimulate
AH outflow, however, the primary surgical strategy is to
manage glaucoma by lowering the patients IOP through
removal of excess AH. Regardless of the technique that is
employed, accurate real-time measurements of IOP and the
ability to restore normal levels are critical in the treatment of
this disease.
ISSN: 2231-5381
http://www.ijettjournal.org
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International Journal of Engineering Trends and Technology (IJETT) Volume 7 Number 3- Jan 2014
ISSN: 2231-5381
http://www.ijettjournal.org
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International Journal of Engineering Trends and Technology (IJETT) Volume 7 Number 3- Jan 2014
silicon wafer and parylene is deposited around the mold.
Each shunt is removed from the master mold and the silicon
is chemically removed.
Flow and pressure regulation is achieved by controlling the
number of and time at which the punctures are made along
the closed end of the shunt. At physiological flow rates,
pressure drops are negligible for the size of our shunt.
Therefore, the majority of the pressure drop in the system
will be concentrated at the valve. In order to promote
drainage of AH out of the anterior chamber, the valve must
be optimized to drain at a flow rate equal to the production of
AH at elevated IOPs. It must open at IOP > 22 mmHg and
close when IOP 22 mmHg to prevent hypo tony.
The mechanical pressure sensor is based on the principle of
operation of a Bourdon tube and consists of a centrally
supported, free-standing parylene spiral-tube formed by a
long, thin-walled toroidal channel. An indicator tip is
integrated at the end of the channel at the circumference of
the spiral as a means for simple optical readout. When a
uniform pressure difference is generated across the channel
walls, a bending moment is created forcing an in-plane radial
and angular deformation of the tube. When the external
pressure is lower than the internal pressure in the channel, the
spiral structure unwinds. When the external pressure exceeds
the internal pressure, the spiral will further coil. This effect
can be monitored by visually tracking the movement of the
indicator tip. Deformation that results is linearly related to
the applied pressure difference and can be correlated to
environmental pressure, or in this case, IOP.
Implantable devices require mechanical attachment to the
biological environment. This is typically achieved by sutures,
tacking, or stapling at the expense of increasing overall
implant size through the addition of anchoring sites. Given
the spatial constraints in the eye and to minimize damage, it
is desirable to implant and secure our sensor and GDD
without needing sutures.
The logical choice for placement of the IOP sensor to
facilitate optical readout would be behind the transparent
cornea on the iris.
E Artificial Nano-Drainage Implant For Glaucoma
Treatment (ANDL)
This technique involves replacing the functionality of
diseased drainage pathway for aqueous humor outflow (i.e.,
trabecular meshwork). By enhancing aqueous humour
outflow, artificial drainage implant will lead to decrease in
IOP and a halt in progression of glaucoma. A nano-drainage
implant consists of a micro porous membrane connected to
an integrated polymeric shaft inserted through sclera into
anterior chamber, thereby, allowing a bypass route for
aqueous
humor
outflow.
Initial studies of aqueous humor perfusion through such
membranes showed protein plugging as a result of
hydrophobic interactions. Myocilin, a strong hydrophobic
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International Journal of Engineering Trends and Technology (IJETT) Volume 7 Number 3- Jan 2014
impanation. The slit between valve and parylene microtube was
sealed by epoxy. After epoxy dried, valve tube assembly was
inserted into DuPont Teflon FET capillary tube and photoresist
was used to seal gap between FET tube and valve tube structure.
FET tube was cut into 2 inch segments in advance and integrated
valve tube assembly was attached to one end of capillary tube.
Whole setup was baked to dry in conventional oven at 100*C.
After photoresist dried, each assembly was connected to testing
setup. Bench-top testing setup used compressed nitrogen to apply
pressure to water.
Fig 5: Full GDD System consisting of dual valve micro-flow regulation
system
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III CONCLUSION
Though there are a lot of ways treating glaucoma. The real
important question is is there a cure? If there is a cure then
it would be really be a great medical breakthrough. The most
promising method of cure seems possible from the studies of
Dr.Drooper of UCLA medical institute. The treatment for
glaucoma has increased tremendously over the years but
finding the cure is more important.
REFERENCES
[1]
Ellis Meng, Po-Jui Chen, Damien Rodger, Yu-Chong Tai, and Mark
Humayun , Implantable parylene MEMS for glaucoma therapy.
[2]
[3]
[4]
[5]
Jun Cheng, Jiang Liu, Damon Wing Kee Wong, Ngan Meng Tan, Beng
Hai Lee, Focal edge association to glaucoma diagnosis.
[6]
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