Evaluation of the IOP-Lowering Effect of a Multi-Pressure Dial at Different Negative Pressure Settings

Swan, Russell; Ferguson, Tanner J.; Shah, Manjool; Muir, Kelly W.; Samuelson, Thomas W.; Ahmed, Iqbal Ike K.; Lindstrom, Richard L.; Radcliffe, Nathan M.; Berdahl, John P.

doi:10.1167/tvst.9.12.19

Cited by 13 publications

(32 citation statements)

References 19 publications

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“…Further, there was no evidence of rebound IOP spikes following the application of negative pressure across all test runs. The results of this study confirm that controlled application of periocular negative pressure leads to a reduction in IOP, supporting the results of prior clinical studies [6,7,10] that reported a reduction in IOP with the MPD system. Collectively, Fig.…”

Section: Discussionsupporting

confidence: 89%

“…Given that the changes in RBP fell below the range of uncertainty in both subjects, we concluded there was no detectable change in RBP with application of negative pressure across all test runs. Multiple prior studies have investigated the IOP-lowering ability of the MPD in both healthy and glaucomatous eyes as measured via the excursion test method, a developed technique for IOP measurement that involves a pneumatonometer across a tonometer tip cover (Tono-penÒ; Reichert Technologies, Buffalo, New York) with a specially adapted version of the MPD goggles [6,7,10]. In a recent study in 65 healthy subjects, Swan et al [6] used three different negative pressure settings, namely 25, 50 and 75% of baseline IOP, and demonstrated a stepwise increase in IOP reduction with increased levels of negative pressure.…”

Section: Discussionmentioning

confidence: 99%

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The Effect of Periocular Negative Pressure Application on Intraocular and Retrobulbar Pressure in Human Cadaver Eyes

Shafer¹,

Ferguson

Chu

et al. 2021

Ophthalmol Ther

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Introduction:To investigate the effect of applying negative pressure (vacuum) to the periocular space on intraocular pressure (IOP) and retrobulbar pressure (RBP) by use of the Multi-Pressure Dial (MPD) system (Equinox Ophthalmic, Inc.). Methods: Two eyes of two full body cadavers were studied. In each subject, the retrobulbar space, posterior segment and intra-goggle space were cannulated to provide direct IOP, RBP and intra-goggle pressure measurements via a pressure transducer data acquisition system. The goggles of the MPD system were placed over the eyes of each subject, and multiple test runs were performed, with negative pressure settings programmed to 5, 10 and 20 mmHg. IOP and RBP measurements were continuously obtained during each run and plotted against time for analysis.Results: For both subjects, the mean reduction (± standard deviation) in IOP was 1.6 ± 0.9 (10%), 3.5 ± 1.8 (23%) and 5.6 ± 2.0 (37%) mmHg at programmed negative pressure levels of -5, -10 and -20 mmHg, respectively. The overall mean change in RBP (mmHg) during negative pressure application was 0.02 ± 0.14 at -5 mmHg, 0.03 ± 0.19 at -10 mmHg and -0.01 ± 0.18 at -20 mmHg. In both subjects, the magnitude of RBP change during application of negative pressure fell below the uncertainty of the measurement system. Conclusions: The application of negative pressure to the periocular space with the MPD decreases IOP but does not affect RBP.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

The Effect of Periocular Negative Pressure Application on Intraocular and Retrobulbar Pressure in Human Cadaver Eyes

Shafer¹,

Ferguson

Chu

et al. 2021

Ophthalmol Ther

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“…In this study, an IOP reduction was also observed in the contralateral, or control eye. Although a minor reduction, this has not been demonstrated in prior studies evaluating the IOP-lowering ability of the device [22,24] and suggests future investigation is warranted evaluating the IOP-lowering ability of the MPD in the nocturnal setting and/or supine position.…”

Section: Discussionmentioning

confidence: 81%

Short-term Evaluation of Negative Pressure Applied by the Multi-Pressure Dial System to Lower Nocturnal IOP: A Prospective, Controlled, Intra-subject Study

Goldberg

Jiminez-Roman²,

Hernández-Oteyza³

et al. 2021

Ophthalmol Ther

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“…The MPD, a novel device currently under investigation, decreases IOP by modulation of atmospheric pressure in a localized, enclosed microenvironment immediately anterior and external to the patient’s eye. With prior work 10 , 13 establishing the IOP-lowering benefit of the device with direct application of negative pressure (e.g. patient awake with eyelids open) to the cornea, this study aimed to investigate with a model whether a mitigation in negative pressure application occurs when applied through tissue (e.g.…”

Section: Discussionmentioning

confidence: 99%

“…Prior work in healthy subjects has demonstrated the titratable IOP-lowering capability of the device at various negative pressure test settings. 10 However, it remains unclear whether the eyelids, when closed, affect the IOP-lowering mechanism created by the localized negative pressure microenvironment. Transmission of negative pressure through a closed eyelid would enable patients to use the therapy while sleeping.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of negative pressure transfer through tissue in a benchtop cornea and eyelid model

et al. 2020

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Purpose: A new glaucoma treatment device, known as the multi-pressure dial (MPD), has been introduced, which offers a novel approach to IOP reduction by delivering negative pressure to the periocular region. Clinical studies have demonstrated the IOP-lowering effect of the MPD via direct measurements using pneumatonometry. It remains unclear whether the eyelids, when closed, affect the transmission of negative pressure and subsequently affect IOP reduction. This study aimed to evaluate whether the transfer of negative pressure and subsequent decrease in IOP are altered by the presence of synthetic eyelid tissue. Methods: A model with 13 different configurations controlling for eyelid material type, presence of slit/opening, and eyelid–cornea contact was employed. The slit modification was employed to mimic the physiologic separation that exists between the eyelids. Baseline IOP within an eye model was set at various levels ranging from 10 to 30 mmHg with applied negative pressure settings of 10, 15, and 20 mmHg utilized at each baseline IOP. The percentage of vacuum transfer was calculated by comparing baseline IOP to resultant IOP measurements following application of vacuum to the system. Results: In the open configuration (without eyelid tissue), the mean % vacuum transfer was 98.7%. The sealed, full-contact configurations exhibited values of 97.4%, 98.8%, and 97.2%. The slit configurations, which closely mimic the physiologic eyelid, demonstrated a mean % vacuum transfer of 98.7% across all settings. Conclusions: The impact of eyelid tissue on transfer of negative pressure can be isolated and evaluated. The presence of eyelid tissue has an insignificant impact on the transfer of negative pressure, and the IOP reduction achievable with the MPD would not be altered with the eyelids closed.

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Evaluation of the IOP-Lowering Effect of a Multi-Pressure Dial at Different Negative Pressure Settings

Cited by 13 publications

References 19 publications

The Effect of Periocular Negative Pressure Application on Intraocular and Retrobulbar Pressure in Human Cadaver Eyes

The Effect of Periocular Negative Pressure Application on Intraocular and Retrobulbar Pressure in Human Cadaver Eyes

Short-term Evaluation of Negative Pressure Applied by the Multi-Pressure Dial System to Lower Nocturnal IOP: A Prospective, Controlled, Intra-subject Study

Evaluation of negative pressure transfer through tissue in a benchtop cornea and eyelid model

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