Do the Math

Medical science is constantly benefiting from interdisciplinary collaboration, but does glaucoma treatment get the same attention? Hard to say, but at least one research collaboration is bringing mathematics to the table with a new model aimed at improving glaucoma treatment (1). Research groups from the Netherlands and the US have used their mathematical model to explore the best way of using an adjustable filtration device to lower intraocular pressure (IOP). Specifically, they found that reducing lumen diameter increases fluid pressure in the device and reduces the risk of the pressure getting too low, whereas increasing the diameter of the lumen only reduces the IOP to an appropriate level when the bleb (the alternative site fluid should be pumped into) is not covered by fibrotic tissue. The mathematical model takes on board certain geometric and physical factors, such as fluid removal from the anterior chamber through the drainage device, drainage into the bleb, and absorption by the subconjunctival tissue.

The data strongly support taking advantage of some anti-fibrotic mechanism when using an adjustable implant. The interdisciplinary approach could also take things one step further from mathematics and into the realms of biomaterials engineering to find a solution to the issue. The work itself not only informs the design of more patient-specific devices, but also adds to the clinical knowledge of how to manage glaucoma after adjustable filtration devices have been implanted, for example,  looking at how to avoid hypotony and fibrotic blocking of bleb drainage.