3-year safety and efficacy results of PreserFlo™ Microshunt in glaucoma patients: A multicentre European cohort study

Karl Mercieca , Raj Bhayani , Jose Maria Martinez-de-la-Casa , Michele Figus , Karsten Klabe , Alessandro Rabiolo , Constance Weber
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Abstract

Purpose

To report three-year outcomes of a multicenter cohort undergoing Preserflo Microshunt surgery (PFMS).

Design

Retrospective cohort study

Methods

Retrospective review of 100 consecutive eyes (91 patients) undergoing PFMS from four tertiary-referral glaucoma centers. Primary outcome were success rates. Secondary outcomes included: intraocular pressure (IOP), best-corrected visual acuity, medication, complications and postoperative interventions.

Results

100 eyes of 91 patients were included. Qualified and complete success rates (95 % CI) were 80 % (72–87 %) and 56 % (47–65 %) for Criterion A (IOP≤21 mmHg), 75 % (67–83 %) and 55 % (46–65 %) for Criterion B (IOP≤18 mmHg), 44 % (31–50 %) and 39 % (30–49 %) for Criterion C (IOP≤15 mmHg) and 10 % (5–16 %) and 10 % (5–16 %) for Criterion D (IOP≤12 mmHg) respectively. Mean IOP decreased from 23.8 mmHg to 14.1 mmHg (reduction of 35.3 %) after 36 months with a reduction of IOP-lowering agents from 2.52 (0 – 4) to 0.69 (0 – 3). 7 eyes (7 %) needed additional glaucoma surgery. Of these, 3 eyes underwent a glaucoma drainage device and 4 eyes had a trabeculectomy.36 eyes received additional procedures after PFMS implantation. Of these, 14 eyes (14 %) underwent a surgical revision and 12 eyes (12 %) a bleb needling procedure.

The complication rate was low: 1 eye developed corneal decompensation and underwent a DMEK after 24 months. 1 eye had a conjunctival erosion requiring a revision surgery. 2 eyes developed a postoperative uveitis that was treated with topical steroids and resolved without further damage. There were no hypotony-related complications.

Conclusions

PFMS surgery is a safe and effective procedure for reducing IOP and pressure-lowering therapy.

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青光眼患者使用 PreserFloTM 微分流术的 3 年安全性和疗效结果:欧洲多中心队列研究
目的报告接受 Preserflo 微分流手术(PFMS)的多中心队列的三年疗效。设计回顾性队列研究方法回顾性分析四家三级青光眼转诊中心接受 Preserflo 微分流手术的 100 只连续眼球(91 名患者)。主要结果为成功率。次要结果包括:眼压(IOP)、最佳矫正视力、用药、并发症和术后干预。标准 A(眼压≤21 mmHg)的合格率和完全成功率(95 % CI)分别为 80 %(72-87 %)和 56 %(47-65 %),标准 B(眼压≤18 mmHg)的合格率和完全成功率分别为 75 %(67-83 %)和 55 %(46-65 %)、标准 C(眼压≤15 毫米汞柱)分别为 44%(31-50%)和 39%(30-49%),标准 D(眼压≤12 毫米汞柱)分别为 10%(5-16%)和 10%(5-16%)。36 个月后,平均眼压从 23.8 mmHg 降至 14.1 mmHg(降低了 35.3%),降眼压药物从 2.52(0 - 4)降至 0.69(0 - 3)。有 7 只眼睛(7%)需要进行额外的青光眼手术。其中,3 只眼睛接受了青光眼引流装置手术,4 只眼睛接受了小梁切除术。并发症发生率很低:1 只眼睛出现角膜失代偿,24 个月后接受了 DMEK。1 只眼睛出现结膜糜烂,需要进行翻修手术。两只眼睛术后出现葡萄膜炎,经局部类固醇治疗后缓解,未造成进一步损害。结论PFMS手术是一种安全有效的降低眼压和降压治疗方法。
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