Ophthalmology Department, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Largo A. Gemelli, 8, 00168, Rome, Italy.
Catholic University Sacro Cuore, Rome, Italy.
Int Ophthalmol. 2023 Sep;43(9):3035-3044. doi: 10.1007/s10792-023-02697-z. Epub 2023 Apr 8.
The aim this study is to determine anterior chamber parameters variations induced by PreserFlo MicroShunt implantation, in the early post-operative days.
This is a prospective observational study on 48 eyes undergoing PreserFlo MicroShunt implantation alone (n = 30) or combined with phacoemulsification (n = 18). Anterior chamber depth (ACD) and volume (ACV), central corneal thickness (CCT) and total corneal astigmatism (TCA) were evaluated pre-operatively, post-operatively at day-1 and at 1 week with the Pentacam tomography.
Intraocular pressure decreased significantly from 20.9 ± 4.0 to 8.0 ± 2.8 mmHg (p < 0.0001) and to 10.8 ± 3.7 mmHg (p = 0.0001) at day-1 and week-1, respectively. TCA varied significantly from baseline (1.5 ± 1.2 D) to both day 1 follow up (2.7 ± 1.9 D, p = 0.0003) and week 1 follow up (2.2 ± 1.6 D, p = 0.02). Nevertheless, only K1 showed a transient flattening at day 1, while K2 value didn't show any statistical variation in the early post-operative period. CCT value rose significantly at day 1 (547 ± 49 vs. 529 ± 32 µm at baseline, p = 0.04), but then returned toward pre-operative values at week 1 (537 ± 39 µm, p = 0.57). In contrast, ACD values changed insignificantly from 3.3 ± 0.9 to 3.7 ± 1.0 mm at day 1 (p = 0.21), and then stabilized at 3.4 ± 0.9 mm (p = 0.82) at week 1 follow up. ACV changed from 150.0 ± 36.2 to 159.5 ± 42.1 mm at day 1 (p = 0.58), and successively to 153.9 ± 37.9 mm at week 1 follow up (p = 0.96). The subgroup analysis in eyes undergoing standalone PreserFlo implantation didn't show significant changes in both ACD and ACV.
PreserFlo implantation minimizes the anterior chamber modifications generated by traditional filtering surgery, inducing low and transient corneal and biometric changes only in the very early postoperative period and insignificant changes to ACD and ACV, label of its safety and minimal invasiveness.
本研究旨在确定 PreserFlo MicroShunt 植入术后早期前房参数的变化。
这是一项前瞻性观察研究，纳入 48 只眼（单独行 PreserFlo MicroShunt 植入术 30 只眼，联合超声乳化术 18 只眼）。使用 Pentacam 断层扫描仪在术前、术后第 1 天和第 1 周评估前房深度（ACD）和前房容积（ACV）、中央角膜厚度（CCT）和总角膜散光（TCA）。
眼内压从 20.9 ± 4.0mmHg 显著下降至术后第 1 天的 8.0 ± 2.8mmHg（p < 0.0001）和第 1 周的 10.8 ± 3.7mmHg（p = 0.0001）。TCA 从基线（1.5 ± 1.2D）显著变化至术后第 1 天随访（2.7 ± 1.9D，p = 0.0003）和第 1 周随访（2.2 ± 1.6D，p = 0.02）。然而，只有 K1 在术后第 1 天出现短暂变平，而 K2 值在术后早期无统计学变化。术后第 1 天 CCT 值显著升高（547 ± 49 比基线时的 529 ± 32µm，p = 0.04），但在第 1 周时恢复至术前值（537 ± 39µm，p = 0.57）。相反，ACD 值从 3.3 ± 0.9mm 变化至术后第 1 天的 3.7 ± 1.0mm（p = 0.21），然后在第 1 周随访时稳定在 3.4 ± 0.9mm（p = 0.82）。ACV 从 150.0 ± 36.2mm 变化至术后第 1 天的 159.5 ± 42.1mm（p = 0.58），随后至第 1 周随访时的 153.9 ± 37.9mm（p = 0.96）。单独行 PreserFlo 植入术的眼亚组分析显示，ACD 和 ACV 均无明显变化。
PreserFlo 植入术最大限度地减少了传统滤过性手术引起的前房改变，仅在术后早期引起轻微、短暂的角膜和生物力学改变，对 ACD 和 ACV 影响较小，这表明其具有安全性和微创性。
