Department of Ophthalmology, Graduate of Medicine, Faculty of Medicine, The University of Tokyo, Tokyo, Japan.
Yotsuya Shirato Eye Clinic, Tokyo, Japan.
Sci Rep. 2024 Nov 18;14(1):28457. doi: 10.1038/s41598-024-80093-y.
To report the frequency of hyphema after PRESERFLO MicroShunt (PMS) surgery using double-step knife in patients with glaucoma and to investigate its relationship with the tube insertion position. Glaucoma patients who underwent PMS surgery were reviewed. Hyphema was defined as visible hemorrhage in the anterior chamber. The insertion position of PMS was confirmed via gonioscopy. Patient backgrounds in the hyphema and non-hyphema groups were compared, and the course of visual acuity (VA), intraocular pressure (IOP), and time to resolution of hyphema were investigated. 65 of 66 eyes were eligible for consideration. Hyphema had occurred in 23 (35%) eyes. At the end of surgery, anterior chamber bleeding was observed under the microscope in 8 of 23 cases (35%). The tube fixation position was on the scleral spur (25 eyes), on the trabecular meshwork (27 eyes), on the Schwalbe line (10 eyes) and on the corneal side (3 eyes). There was no significant difference of the site of tube insertion between the two groups. All cases of hyphema spontaneously resolved within a few weeks, with stable IOP and recovered VA. It is worth noting that in PMS surgery using the double-step knife, hyphema may occur high frequency even if the tube insertion site is accurately positioned. Patients should be informed of the risk of hyphema before the surgery.
报告采用双步刀行 PRESERFLO MicroShunt（PMS）手术治疗青光眼患者后发生前房积血的频率，并探讨其与引流管插入位置的关系。回顾行 PMS 手术的青光眼患者。前房积血定义为前房可见出血。通过房角镜确认 PMS 的插入位置。比较前房积血组和非前房积血组患者的背景，并调查视力（VA）、眼压（IOP）和前房积血消退时间的变化。66 只眼中有 65 只符合条件。23 只（35%）眼中发生前房积血。在手术结束时，在显微镜下观察到 23 例中的 8 例（35%）有前房出血。引流管固定位置在巩膜突（25 只眼）、小梁网（27 只眼）、Schwalbe 线（10 只眼）和角膜侧（3 只眼）。两组之间引流管插入部位无显著差异。所有前房积血病例均在数周内自发消退，眼压稳定，视力恢复。值得注意的是，在使用双步刀的 PMS 手术中，即使引流管插入位置准确，前房积血的发生率也可能很高。在手术前应告知患者前房积血的风险。
