Department of Ophthalmology, Medical University of Bialystok, Kilinskiego 1 STR, 15-089 Bialystok, Poland.
Int J Environ Res Public Health. 2023 Feb 7;20(4):2904. doi: 10.3390/ijerph20042904.
Recently, the quest for novel glaucoma surgical techniques and devices has been underway. Trabeculectomy remains the gold standard, but it requires the implantation of glaucoma drainage devices and frequent follow-ups, and it also carries a high risk of serious complications. The need for less invasive and safer procedures has led to the development of minimally invasive glaucoma surgery (MIGS), particularly for patients with mild-to-moderate disease. Among them, minimally invasive bleb surgery seems to be effective in classical glaucoma surgery, while maintaining MIGS benefits. The relatively new PreserFlo MicroShunt (Santen, Osaka, Japan) is registered in Europe. It was released in 2019 for the treatment of patients with early-to-advanced open-angle glaucoma, where intraocular pressure (IOP) remains uncontrolled while on maximum tolerated medication and/or where glaucoma progression warrants surgery. This review focuses on the place of the PreserFlo MicroShunt, characterized by ab externo implantation, among MIGS procedures, discussing its advantages and disadvantages. The mechanisms of action, technical aspects, efficacy, and safety issues are summarized. The surgical technique, its efficacy, and safety profile are described, and directions for future studies are indicated. The PreserFlo MicroShunt ensures a high safety profile, minimal anatomical disruption, meaningful IOP-lowering effect, and ease of use for patients and physicians.
最近，人们一直在探索新的青光眼手术技术和设备。小梁切除术仍然是金标准，但它需要植入青光眼引流装置和频繁的随访，而且还存在严重并发症的高风险。人们需要更微创和更安全的手术，这导致了微创青光眼手术（MIGS）的发展，特别是对于轻度到中度疾病的患者。其中，微创滤过泡手术似乎在经典青光眼手术中有效，同时保持了 MIGS 的优势。相对较新的 PreserFlo MicroShunt（三井化学，日本大阪）已在欧洲注册。它于 2019 年发布，用于治疗早期至晚期开角型青光眼患者，这些患者在最大耐受药物治疗下眼压（IOP）仍不受控制，或者青光眼进展需要手术。本综述重点介绍了 PreserFlo MicroShunt 的位置，其特点是经外植入，在 MIGS 手术中讨论其优缺点。总结了作用机制、技术方面、疗效和安全性问题。描述了手术技术、疗效和安全性概况，并指出了未来研究的方向。PreserFlo MicroShunt 确保了高安全性、最小的解剖破坏、有意义的眼压降低效果，以及患者和医生使用的便利性。
