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

Abstract

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

“…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, the decrease in IOP observed in the absence of pressure changes in the retro-orbital tissue indicates that the MPD system is capable of favorably modifying the translaminar pressure difference, a pressure differential shown to be important in the pathogenesis of glaucoma [ 11 – 14 ].…”

“…The IOP-lowering results demonstrated in this present study align with the results reported in prior clinical studies that have evaluated the IOP-lowering ability of the MPD [ 6 , 7 , 10 ]. In both subjects in the present study, an increase in the programmed level of negative pressure within the goggles corresponded to an increased reduction in IOP.…”

“…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-pen®; 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.…”

“…The results of this study support the capability of the MPD system to provide a meaningful reduction in IOP even in patients with lower baseline IOP. An additional, recently published study by Goldberg et al [ 7 ] assessed the nocturnal IOP-lowering ability of the device by assessing IOP measurements at three separate time points throughout the night in subjects with open-angle glaucoma who were in the supine position. At all three time points (10:30 p.m., 2:00 a.m., 5:30 a.m.), the IOP reduction exceeded 30% while the MPD was worn with a negative pressure setting programmed to 60% of baseline IOP for all subjects.…”

“…Recently, a novel IOP-lowering device known as the Multi-Pressure Dial system or MPD (Equinox Ophthalmic, Inc., Newport Beach, CA, USA) was introduced onto the market [ 4 – 6 ]. The MPD represents the first non-invasive, non-pharmaceutical, non-surgical approach to IOP reduction [ 4 , 7 ].…”