STARfloTM: A Suprachoroidal Drainage Implant Made from STAR® Biomaterial

  • Sayeh Pourjavan
  • Nathalie J. M. Collignon
  • Veva De Groot
  • Rich A. Eiferman
  • Andrew J. Marshall
  • Cecile J. RoyEmail author


STARfloTM is a new glaucoma drainage device (GDD) comprised entirely of Healionics’ proprietary STAR® Biomaterial, a precision-pore structured silicone. The STARfloTM relies on extensive research and studies conducted for several years on the STAR® Biomaterial as implantable material and on STARflo predecessors in the ophthalmic field – the CELLplant and the ClarifEYE. The device’s bleb-free drainage mechanism, soft-sponge design, and fibrosis-resistant pore geometry give it several advantages over competing GDDs. The safety and the performances of the STARflo device were demonstrated on animals while early results on human shows encouraging results in the control of the IOP with a reduction of glaucoma medications.


Anterior Chamber Aqueous Humor Trabecular Meshwork Pore Throat Glaucoma Medication 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



The authors express warm thanks to M. Maginness (PhD, Healionics Corporation), Dr. R.E. Norquist (PhD, Wound Healing Of Oklahoma, Inc.), and Dr. C. Woods (DVM, BioVeteria Life Sciences, LLC) for their contribution and inputs in this chapter.

Supplementary material

Video 22.1

(MOV 13514 kb)

Video 22.2

(WMV 405425 kb)


  1. 1.
    Bill A, Philips CI. Uveoscleral drainage of aqueous humor in human eye. Exp Eye Res. 1971;12(3):275–81.PubMedCrossRefGoogle Scholar
  2. 2.
    Toris CB, Yablonski ME, Wang YL, Camras CB. Aqueous humor dynamics in the aging human eye. Am J Ophthalmol. 1999;127(4):407–12.PubMedCrossRefGoogle Scholar
  3. 3.
    Weinreb RN. Uveoscleral outflow: the other outflow pathway. J Glaucoma. 2000;9(5):343–5.PubMedCrossRefGoogle Scholar
  4. 4.
    Weinreb RN, Toris CB, Gabelt BT, Lindsey JD, Kaufman PL. Effects of prostaglandins on the aqueous humor outflow pathways. Surv Ophthalmol. 2002;47 Suppl 1:S53–64.PubMedCrossRefGoogle Scholar
  5. 5.
    Mosaed S, Minckler DS. Aqueous shunt in the treatment of glaucoma. Expert Rev Med Devices. 2010;7(5):661–6.PubMedCrossRefGoogle Scholar
  6. 6.
    Boyle JW, Netland PA. Incisional therapies: shunts and valved implants. In: Schacknow PN, Samples JR, editors. The glaucoma book – a practical, evidence-based approach to patient care. New York: Springer; 2010. p. 813–30.Google Scholar
  7. 7.
    Ratner BD, Marshall A, inventors; University of Washington, assignee. Porous biomaterials. United States patent US 7972628 B2, 5 July 2011.Google Scholar
  8. 8.
    Ratner BD, Marshall A, inventors; University of Washington, assignee. Crosslinked porous biomaterials. United States Patent US 8318193, 27 Nov 2012.Google Scholar
  9. 9.
    Ratner BD, Marshall A, inventors; University of Washington, assignee. Novel porous biomaterials that support vascular in-growth. European Patent EP 1670385, 23 Jan 2013.Google Scholar
  10. 10.
    Nordquist RE, Li B, inventors; Wound Healing of Oklahoma, assignee. Method and apparatus for lowering the intraocular pressure of an eye. United States Patent US 5704907, 6 Jan 1998.Google Scholar
  11. 11.
    Nordquist RE, Li B, inventors; Premier Laser Systems Inc., assignee. Method and apparatus for lowering the intraocular pressure of an eye. United States Patent US 6102045, 15 Aug 2000.Google Scholar
  12. 12.
    Rollet M, Moreau M. Traitement de l’hypopyon par le drainage capillaire de la chambre antérieure. Rev Gen Ophthalmol (Paris). 1906;25:481–9. French.Google Scholar
  13. 13.
    Hong C-HH, Arosemena A, Zurakowski D, Ayyala RS. Glaucoma drainage devices: a systematic literature review and current controversies. Surv Ophthalmol. 2005;50(1):48–60.PubMedCrossRefGoogle Scholar
  14. 14.
    Luntz MH, Harrison R. Alloplastic devices in glaucoma surgery: setons. In: Lim ASM, series editor. Glaucoma surgery. Singapore: World Scientific; 1994. p. 153–63.Google Scholar
  15. 15.
    Lisk JR, Memmen JE, Hampton SM, Nordquist RE, Robledo PV, Tai M-K, inventors; Medtronic-Xomed INc, assignee. Article and method for ocular aqueous drainage. United States Patent US 7160264 B2, 9 Jan 2007.Google Scholar
  16. 16.
    Lisk JR, Memmen JE, Hampton SM, Nordquist RE, Robledo PV, Tai M-K, inventors; Medtronic-Xomed Inc., assignee. Device for ocular aqueous drainage. European Patent EP 1578319B1, 23 Jan 2010.Google Scholar
  17. 17.
    Sabbagh L. Early results good with glaucoma seton. Ophthalmol Times. 1995;20(40):10–2.Google Scholar
  18. 18.
    Intraocular Implantation Study in the Rabbit. NAMSA study protocol and report # 02T0101300, 2002.Google Scholar
  19. 19.
    Martson M, Viljanto J, Hurme T, Laippala P, Saukko P. Is cellulose degradable or stable as implantation material? An in vivo subcutaneous study in the rat. Biomaterials. 1999;20(21):1989–95.PubMedCrossRefGoogle Scholar
  20. 20.
    Marshall AJ, Ratner BD. Quantitative characterization of sphere-templated porous biomaterials. AIChE J. 2005;51(4):1221–32.CrossRefGoogle Scholar
  21. 21.
    Marshall A. Hydrogels with well-defined pore structure for biomaterials applications. PhD dissertation, University of Washington; 2004: AAT 3151637.Google Scholar
  22. 22.
    Krombach F, Münzing S, Allmeling AM, Gerlach JT, Behr J, Dörger M. Cell size of alveolar macrophages: an interspecies comparison. Environ Health Perspect. 1997;105 Suppl 5:1261–3.PubMedCentralPubMedCrossRefGoogle Scholar
  23. 23.
    Brauker JH, Carr-Brendel VE, Martinson LA, Crudele J, Johnston WD, Johnson RC. Neovascularization of synthetic membranes directed by membrane microarchitecture. J Biomed Mater Res. 1995;29(12):1517–24.PubMedCrossRefGoogle Scholar
  24. 24.
    Sharkaway AA, Klitzman B, Truskey GA, Reichert WM. Engineering the tissue which encapsulates subcutaneous implants. II. Plasma-tissue exchange properties. J Biomed Mater Res. 1998;40(4):586–97.CrossRefGoogle Scholar
  25. 25.
    Bae HB, Kim CS, Ahn BH. A membranous drainage implant in glaucoma filtering surgery: animal trial. Korean J Opthalmol. 1988;2:49–56.Google Scholar
  26. 26.
    Terasaki D, Sobel M, Irvin C, Wijelath E, Ratner BD. Biomaterial-Induced Angiogenesis To Adress Peripheral Vascular Disease: The Application of Sphere Templated Hydrogels. In: Scholz C, Kressler J, editors. Tailored polymer architectures for pharmaceutical and biomedical applications. ACS Symp Ser 2013. p. 245–57.Google Scholar
  27. 27.
    Madden LR, Mortisen DJ, Sussman EM, Dupras SK, Fugate JA, Cuy JL, et al. Proangiogenic scaffolds as functional templates for cardiac tissue engineering. Proc Natl Acad Sci U S A. 2010;107(34):15211–6.PubMedCentralPubMedCrossRefGoogle Scholar
  28. 28.
    Marshall AJ, Alvarez M, Maginness M, inventors; Healionics Corporation, assignee. Implantable medical devices having microporous surface layers and method for reducing foreign body response to the same. United States Patent US 2011/0257623 A1, 20 Oct 2011.Google Scholar
  29. 29.
    Ayyala RS, Michelini-Norris B, Flores A, Haller E, Margo CE. Comparison of different biomaterials for glaucoma drainage devices: part 2. Arch Ophthalmol. 2000;118(18):1081–4.PubMedCrossRefGoogle Scholar
  30. 30.
    Ocular Irritation Study of STARflo glaucoma implant following implantation in the anterior chamber of the rabbit eye. NAMSA study protocol and report # 10T5296802, 2010.Google Scholar
  31. 31.
    Biotechnol Bioeng. 2012;109(8):C1.Google Scholar
  32. 32.
    Roberts S, Woods C. Preliminary report: effect of a novel porous implant in refractory glaucomatous dogs. In: Veterinary ophthalmology. Abstracts: 39th annual meeting of the American College of Veterinary Ophthalmologists, Boston, 15–18 Oct 2008, p. 423.Google Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Sayeh Pourjavan
    • 1
  • Nathalie J. M. Collignon
    • 2
  • Veva De Groot
    • 3
  • Rich A. Eiferman
    • 4
  • Andrew J. Marshall
    • 5
  • Cecile J. Roy
    • 6
    Email author
  1. 1.Department of OphthalmologyCliniques Universitaires St. Luc, UCLBrusselsBelgium
  2. 2.Division of Neuro-Ophthtalmology and Glaucoma, Department of OphthalmologyUniversity Hospital of LiègeLiègeBelgium
  3. 3.Department of OphthalmologyUniversity Hospital AntwerpEdegemBelgium
  4. 4.Department of OphthalmologyUniversity of LouisvilleLouisvilleUSA
  5. 5.Healionics CorporationSeattleUSA
  6. 6.iSTAR Medical SAIsnesBelgium

Personalised recommendations