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术中初次部分阻断 PreserFlo 微分流管以预防术后早期低眼压。

Intraoperative primary partial occlusion of the PreserFlo MicroShunt to prevent initial postoperative hypotony.

机构信息

Department of Ophthalmology, Medical Faculty, University Hospital of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany.

出版信息

Int Ophthalmol. 2023 Aug;43(8):2643-2651. doi: 10.1007/s10792-023-02664-8. Epub 2023 Mar 11.

Abstract

PURPOSE

The aim of the underlying study was to present a new surgical method in PreserFlo MicroShunt surgery for glaucoma. A removable polyamide suture was placed into the lumen of the MicroShunt during implantation to prevent early postoperative hypotony.

METHODS

Thirty-one patients undergoing stand-alone glaucoma surgery with implantation of a PreserFlo MicroShunt and an intraluminal occlusion were retrospectively reviewed and compared to a control group without occlusion. Inclusion criteria were diagnosis of primary open-angle glaucoma or secondary open-angle glaucoma due to pseudoexfoliation or pigment dispersion. Patients with a history of filtrating glaucoma surgery were excluded.

RESULTS

IOP decreased from 26.9 ± 6.6 to 18.0 ± 9.5 mmHg at the first postoperative day after PreserFlo MicroShunt implantation. Postoperative removal of the occluding suture resulted in a mean IOP reduction in 11.1 ± 7.6 mmHg. Mean visual acuity was 0.43 ± 0.24 logMAR during the first postoperative examination. The interval with the occluding intraluminal suture in place varied from days to 2-3 weeks. Patients were followed up to 1 year.

CONCLUSION

Implantation of a PreserFlo MicroShunt combined with an intraluminal suture prevented postoperative hypotony in all patients. Mean postoperative pressure was reduced despite the occluding suture in place.

摘要

目的

本研究旨在介绍一种新的青光眼 PreserFlo 微分流手术方法。在植入过程中,将可移除的聚酰胺缝线放置在微分流管的管腔内,以防止术后早期低眼压。

方法

回顾性分析了 31 例接受单纯青光眼手术、植入 PreserFlo 微分流管并进行管内闭塞的患者,并与无闭塞的对照组进行比较。纳入标准为原发性开角型青光眼或因剥脱或色素播散引起的继发性开角型青光眼的诊断。排除有滤过性青光眼手术史的患者。

结果

在植入 PreserFlo 微分流管后的第一天,IOP 从 26.9±6.6mmHg 降至 18.0±9.5mmHg。术后移除闭塞缝线导致平均眼压降低 11.1±7.6mmHg。术后第一次检查时平均视力为 0.43±0.24 logMAR。带闭塞管内缝线的间隔从几天到 2-3 周不等。患者随访 1 年。

结论

在所有患者中,植入 PreserFlo 微分流管联合管内缝线可防止术后低眼压。尽管存在闭塞缝线,但术后平均眼压仍有所降低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2be8/10371896/17fa44a9e585/10792_2023_2664_Fig1_HTML.jpg

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