The use of intraluminal PRESERFLO stenting in avoiding early postoperative hypotony.

IF 2.4 3区 医学 Q2 OPHTHALMOLOGY Graefe’s Archive for Clinical and Experimental Ophthalmology Pub Date : 2024-12-01 Epub Date: 2024-07-06 DOI:10.1007/s00417-024-06567-x
Raoul Verma-Fuehring, Mohamad Dakroub, Ahmed Bamousa, Gunda Kann, Jost Hillenkamp, Daniel Kampik
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Abstract

Purpose: Postoperative hypotony following PRESERFLO MicroShunt (PMS) implantation is a frequent cause of complications such as choroidal detachment and hypotony maculopathy. This study aims at evaluating the impact of intraluminal stenting of the PMS during the early postoperative period.

Methods: We retrospectively analyzed the data of 97 patients who underwent PMS implantation with intraoperative placement of a Nylon 10-0 suture as intraluminal stent (PStent) and compared the outcomes to those of an existing database of the traditional MicroShunt implantation technique (PTrad, n = 120). The primary outcome measure was the intraocular pressure (IOP) at one week postoperatively. As a secondary outcome measure, adverse hypotony, defined as an IOP ≤ 5 mmHg with significant choroidal effusion and/or anterior chamber shallowing or the presence of macular folds was also assessed. Additionally, the time to stent removal and the IOP one week after stent removal were reported.

Results: Preoperative median IOP was 25.0 (20.5-30.3) mmHg in PStent and 25.0 (19.3-32.0) mmHg in PTrad (p = 0.62). One week after surgery, the median IOP dropped to 10.0 (8.0-13.0) mmHg in PStent and 7.0 (5.0-9.0) in PTrad (p < 0.01). At one month, the IOP was 12.0 (10.0-14.0) mmHg in PStent and 10.0 (8.0-11.0) mmHg in PTrad (p < 0.01). After 3 months, both groups showed similar median IOP levels of 11.0 (8.0-13.5) mmHg and 10.0 (9.75-13.0) mmHg in PStent and PTrad, respectively (p = 0.66). The presence of adverse hypotony was significantly lower in PStent compared to PTrad (6.2% vs 15.8%, p < 0.05). In PStent the stent was removed after 30.0 (21.0-42.5) days. One week after stent removal the mean IOP drop was 6.1 ± 0.5 mmHg (p < 0.01).

Conclusion: In the early follow-up period, intraluminal stenting of the PMS appears to be safe and effective in controlling the IOP while reducing early postoperative hypotony. Surgical success is not compromised by stent placement. Based on our data, it is recommended to remove the suture two to six weeks after surgery for most patients with uncomplicated postoperative clinical findings.

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使用腔内 PRESERFLO 支架避免术后早期低血压。
目的:PRESERFLO 微分流术(PMS)植入术后低血压是脉络膜脱离和低血压性黄斑病变等并发症的常见原因。本研究旨在评估在术后早期为 PMS 植入腔内支架的影响:我们回顾性分析了 97 例接受 PMS 植入术并在术中放置尼龙 10-0 缝线作为腔内支架(PStent)的患者的数据,并将其结果与现有数据库中传统 MicroShunt 植入技术(PTrad,n = 120)的结果进行了比较。主要结果指标是术后一周的眼压(IOP)。作为次要结果指标,还评估了不良低眼压,即眼压≤5 mmHg,伴有明显脉络膜渗出和/或前房变浅或出现黄斑皱褶。此外,还报告了支架移除时间和支架移除后一周的眼压:结果:PStent 患者的术前中位眼压为 25.0(20.5-30.3)mmHg,PTrad 患者的术前中位眼压为 25.0(19.3-32.0)mmHg(p = 0.62)。术后一周,PStent 的中位眼压降至 10.0(8.0-13.0)mmHg,PTrad 的中位眼压降至 7.0(5.0-9.0)mmHg(P = 0.62):在早期随访期间,PMS 腔内支架植入术似乎可以安全有效地控制眼压,同时减少术后早期低血压。放置支架不会影响手术成功率。根据我们的数据,建议大多数术后临床表现不复杂的患者在术后两到六周拆除缝线。
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来源期刊
CiteScore
5.40
自引率
7.40%
发文量
398
审稿时长
3 months
期刊介绍: Graefe''s Archive for Clinical and Experimental Ophthalmology is a distinguished international journal that presents original clinical reports and clini-cally relevant experimental studies. Founded in 1854 by Albrecht von Graefe to serve as a source of useful clinical information and a stimulus for discussion, the journal has published articles by leading ophthalmologists and vision research scientists for more than a century. With peer review by an international Editorial Board and prompt English-language publication, Graefe''s Archive provides rapid dissemination of clinical and clinically related experimental information.
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