Development of a Closed-Loop, Implantable Electroceutical Device for Glaucoma

Glaucoma is the leading cause of irreversible blindness worldwide. While current therapies aim to lower elevated intraocular pressure (IOP) to prevent blindness, they often do not provide the desired long-term efficacy, can fail over time, and have systemic side effects. Electroceutical stimulation can be a solution to many of these current issues with glaucoma treatment, as it is believed to have fewer systemic side effects and quicker response times. The goal of this work is to develop and demonstrate a novel system using electrical stimulation to lower intraocular pressure. I present data from a human clinical study and an ongoing clinical trial of the IOPTx™ system, a wearable electroceutical for treating glaucoma, that provides preliminary evidence of efficacy and safety. Furthermore, no current glaucoma treatments allow for closed-loop, continuous monitoring of IOP, requiring more frequent doctor visits or forcing patients and clinicians to operate in the dark. Using an electroceutical therapeutic device with closed-loop feedback and continuous IOP recording can improve glaucoma management. I combined a pressure sensor with this electroceutical therapy, implanted the sensor and stimulation coils in rabbits, and stimulated the eyes. However, to better understand the optimal stimulation parameters, long-term effects, and mechanisms of action, an integrated circuit is designed as part of a fully implantable, closed-loop device. The chip was fabricated in 0.18 µm CMOS process and validated on the benchtop and in vivo. In the future, this electroceutical device has the potential to be a novel treatment for patients suffering from glaucoma.