Chilmonczyk Małgorzata, Gołaszewska Kinga, Saeed Emil, Konopińska Joanna
Department of Ophthalmology, Medical University of Bialystok, M. Sklodowskiej-Curie 24 A STR, 15-276, Bialystok, Poland.
Ophthalmol Ther. 2025 Jan;14(1):41-54. doi: 10.1007/s40123-024-01068-w. Epub 2024 Dec 5.
Glaucoma and cataract often coexist. Patients with both conditions who qualify for surgical treatment may undergo either a combined surgical procedure or sequential treatments such as cataract surgery followed by an antiglaucoma procedure. A combined procedure with phacoemulsification is related to an increased risk of fibrosis of the filtering bleb; however, it is a rational approach for patients with high intraocular pressure and clinically significant lens opacification. Trabeculectomy has been a traditional filtration procedure for decades, effectively lowering intraocular pressure. It is highly effective; however, it may cause sight-threatening complications. The Preserflo MicroShunt, introduced less than a decade ago in the field of glaucoma surgery, has shown similar hypotensive efficacy to trabeculectomy, and is a less invasive procedure with a better safety profile. Despite their shared mechanism of action to reduce intraocular pressure, the two procedures differ in the extent of scleral incision and filtration bleb morphology, which may influence the extent of the post-surgery inflammation process. This review evaluated and compared reports on the efficacy and safety of Preserflo MicroShunt implantation as a standalone procedure versus combined with cataract removal in surgical treatment for patients with open-angle glaucoma and concomitant cataract.
青光眼和白内障常常并存。符合手术治疗条件的这两种疾病患者,可接受联合手术或序贯治疗,如先进行白内障手术,随后进行抗青光眼手术。超声乳化白内障吸除联合手术与滤过泡纤维化风险增加有关;然而,对于眼内压高且晶状体混浊具有临床意义的患者而言,这是一种合理的治疗方法。小梁切除术作为一种传统的滤过手术已有数十年历史,能有效降低眼内压。它非常有效;然而,可能会引发威胁视力的并发症。Preserflo微型分流器在青光眼手术领域推出不到十年,已显示出与小梁切除术相似的降压效果,且是一种侵入性较小、安全性更高的手术。尽管这两种手术降低眼内压的作用机制相同,但在巩膜切口范围和滤过泡形态方面存在差异,这可能会影响术后炎症反应的程度。本综述评估并比较了关于Preserflo微型分流器单独植入与联合白内障摘除术治疗开角型青光眼合并白内障患者的疗效和安全性的报告。