Steiner Stefan, Resch Hemma, Kiss Barbara, Vass Clemens
Department of Ophthalmology, Medical University of Vienna, 1090 Vienna, Austria.
Department of Ophthalmology, Sanatorium Hera, 1090 Vienna, Austria.
J Clin Med. 2024 Mar 29;13(7):1979. doi: 10.3390/jcm13071979.
The purpose of this study was to evaluate the effectiveness and safety of the PreserFlo™ microshunt (PMS) using a 25-Gauge vs. 27-Gauge needle tract. : This is a prospective postoperative examination of 60 glaucoma eyes that received a PMS. The main outcome measures were intraocular pressure (IOP), glaucoma drug score (GDS), Kaplan-Meier success rates, complications, and secondary intervention rates. Two subgroups were formed for data comparison: 27-Gauge (27G), and 25-Gauge (25G). Success was defined as IOP < 18 mmHg together with ≥20% IOP reduction with medication allowed (qualified success = QS18) or not (full success = FS18). : IOP and GDS were reduced from baseline to the 1-year study visit as follows: All eyes from 23.4 ± 8.6 mmHg (3.1 ± 0.9) to 15.1 ± 5.9 mmHg (0.8 ± 1.1); 25G from 24.2 ± 7.3 mmHg (3.0 ± 0.8) to 12.7 ± 2.7 mmHg (0.5 ± 0.8); and 27G from 23.1 ± 9.2 mmHg (3.1 ± 1.0) to 16.2 ± 6.7 mmHg (0.9 ± 1.2). IOP at one year was lower in the 25G group compared to the 27G group ( = 0.035). Bleb needling was required in eight (13.3%) eyes and open bleb revisions in three (5.0%). Transient hypotony occurred in 21% and choroidal effusion in 8% of all eyes. Choroidal effusions were more frequent in the 25G group (21%) compared to the 27G group (2%, = 0.031). One-year success rates were significantly higher in the 25G group compared to the 27G group for both QS18 (25G: 67.9% vs. 27G: 35.7%, = 0.002) and FS18 (25G: 63.6% vs. 27G: 29.2%, = 0.007). : The PreserFlo microshunt is an effective and safe glaucoma surgery with a low rate of bleb revisions or needlings. We show that the 25G needle tract might be more efficient for IOP control at the cost of increased IOP-related complications compared to 27G.
本研究的目的是评估使用25号与27号针道的PreserFlo™微型分流器（PMS）的有效性和安全性。这是一项对60只接受PMS的青光眼患眼进行的前瞻性术后检查。主要观察指标为眼压（IOP）、青光眼药物评分（GDS）、Kaplan-Meier成功率、并发症及二次干预率。为进行数据比较形成了两个亚组：27号（27G）和25号（25G）。成功定义为眼压<18 mmHg且允许使用药物使眼压降低≥20%（合格成功=QS18）或未使用药物使眼压降低≥20%（完全成功=FS18）。眼压和GDS从基线至1年研究访视时的降低情况如下：所有患眼从23.4±8.6 mmHg（3.1±0.9）降至15.1±5.9 mmHg（0.8±1.1）；25G组从24.2±7.3 mmHg（3.0±0.8）降至12.7±2.7 mmHg（0.5±0.8）；27G组从23.1±9.2 mmHg（3.1±1.0）降至16.2±6.7 mmHg（0.9±1.2）。25G组1年时的眼压低于27G组（P=0.035）。8只（13.3%）患眼需要进行滤泡针刺，3只（5.0%）需要进行开放滤泡修复。所有患眼中21%出现短暂性低眼压，8%出现脉络膜渗漏。25G组脉络膜渗漏（21%）比27G组（2%，P=0.031）更常见。25G组QS18（25G：67.9% vs. 27G：35.7%，P=0.002）和FS18（25G：63.6% vs. 27G：29.2%，P=0.007）的1年成功率均显著高于27G组。PreserFlo微型分流器是一种有效且安全的青光眼手术，滤泡修复或针刺率低。我们发现，与27G相比，25G针道可能在控制眼压方面更有效，但代价是增加了与眼压相关的并发症。
