Kyubae Lee1, Wungrak Choi2, Si Yeong Kim1, Eon-Bee Lee3, Won Take Oh1, Jeongeun Park1, Chan Hee Lee1, Jihei Sara Lee2, Hyoung Won Bae2, Dong-Su Jang4, Kang Suk Lee1,5, Se Won Yi1,5, Mi-Lan Kang1,5, Chan Yun Kim,2* and Hak-Joon Sung1,5*
1Department of Medical Engineering, Yonsei University College of Medicine, 50–1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea
2Department of Ophthalmology, Institute of Vision Research, Yonsei University College of Medicine, 50–1 Yonsei-ro, Seodaemun-gu, Seoul0 3722, Republic of Korea
3Laboratory of Veterinary Pharmacokinetics and Pharmacodynamics, College of Veterinary Medicine, Kyungpook National University, Daegu 41566, Republic of Korea
4Office of Research Affairs, Yonsei University College of Medicine, 50–1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea
5TMD LAB Co., Ltd, 6th Floor, 31, Gwangnaru-ro 8-gil, Seongdong-gu, Seoul 04799, Republic of Korea
K.L. and W.C. contributed equally to this work as co-first authors.
CORRESPONDING AUTHORS : Chan Yun Kim, Hak-Joon Sung
There is an unmet need in the glaucoma clinic to control changes in the intraocular pressure (IOP), i.e., patient-specific hypotony and tissue fibrosis-mediated ocular hypertension, owing to the fixed tube diameter of the glaucoma drainage device. As a potential solution, the tube diameter can be adjusted, depending on the IOP, by shape memory polymer (SMP) and clinical laser systems, which can control the energy level, focus, and frequency by minimizing untargeted influences. To develop a translatable device, a laser-responsive SMP with two additional elements: i) a tube with an intimal gel coating to release 5-fluorouracil as an anti-fibrotic drug and ii) a safety lock ring to block late hypotony in special cases is employed. When the SMP tube is inserted into a silicone tube and wrapped externally by the ring, intimal gel degradation and argon laser-triggered diameter increase enable a three-step IOP control. Sustained drug release of the intimal gel suppresses tissue fibrosis, and the ring prevents late hypotony by externally squeezing the silicone tube. The advanced design and functions are validated using computational in vitro and rabbit glaucoma models by determining clinic-friendly argon laser parameters.