Lüke Jan Niklas, Popp Constantin, Gietzelt Caroline, Steinberg Florian, Lüke Vincent, Lappa Alexandra, Dietlein Thomas, Enders Philip
Department of Ophthalmology, Medical Faculty, University Hospital of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany.
Department of Ophthalmology Medical Faculty, University Hospital of Cologne, Kerpener Str. 62, 50937, Cologne, Germany.
BMC Ophthalmol. 2025 Jan 17;25(1):26. doi: 10.1186/s12886-024-03838-3.
BACKGROUND/ AIMS: To analyze the longitudinal change in Bruch's membrane opening minimal rim width (BMO-MRW) and peripapillary retinal nerve fiber layer (pRNFL) thickness using optical coherence tomography (OCT) after implantation of a PRESERFLO® microshunt for surgical glaucoma management in adult glaucoma patients.
Retrospective data analysis of 59 eyes of 59 participants undergoing implantation of a PRESERFLO microshunt between 2019 and 2022 at a tertiary center for glaucoma management. Surgical management included primary temporary occlusion of the glaucoma shunt to prevent early hypotony. Pre- and post-operative OCT examinations of the optic nerve head (ONH) and intraocular pressure (IOP) were assessed. Longitudinal change in morphometric spectral domain OCT parameters of the ONH was correlated to change in IOP.
BMO-MRW increased significantly between baseline (BL) and follow-up (FU) within the first three months after surgery (BL = 171.15 ± 66.80 μm; FU = 180.78 ± 70.394 μm; p = 0.034). For the same postoperative period, the mean preoperative IOP of 24.97 ± 7.22mmHg was lowered after surgery to 13.70 ± 5.09 mmHg. Eighteen months after surgery, there was no significant change in BMO-MRW compared to baseline (BL = 169.83 ± 52.69 μm; FU = 164.98 ± 55.85 μm; p = 0.271), while mean IOP was 13.08 ± 4.48 mmHg. A decrease in IOP correlated significantly with a change in BMO-MRW (r = 0.453, p < 0.05) three months after surgery. Peripapillary RNFL thickness was unchanged in follow-up after three months (p > 0.16) and significantly decreased in later follow-up (p = 0.009).
PRESERFLO® microshunt implantation with primary temporary occlusion leads to a significant transient increase in BMO-MRW. This phenomenon is also known as structural reversal of disc cupping (SRDC). The effect seems to be less pronounced and of shorter duration when compared to previous data after trabeculectomy with comparable pre- and postoperative IOP levels.
背景/目的：使用光学相干断层扫描（OCT）分析在成年青光眼患者中植入PRESERFLO®微型分流器进行青光眼手术治疗后， Bruch膜开口最小边缘宽度（BMO-MRW）和视乳头周围视网膜神经纤维层（pRNFL）厚度的纵向变化。
对2019年至2022年在一家三级青光眼治疗中心接受PRESERFLO微型分流器植入手术的59名参与者的59只眼睛进行回顾性数据分析。手术管理包括对青光眼分流器进行初步临时阻塞以防止早期低眼压。对视神经乳头（ONH）和眼压（IOP）进行术前和术后OCT检查。ONH形态学光谱域OCT参数的纵向变化与IOP变化相关。
术后前三个月内，基线（BL）和随访（FU）之间BMO-MRW显著增加（BL = 171.15±66.80μm；FU = 180.78±70.394μm；p = 0.034）。在同一术后期间，术前平均眼压24.97±7.22mmHg术后降至13.70±5.09mmHg。术后18个月，与基线相比，BMO-MRW无显著变化（BL = 169.83±52.69μm；FU = 164.98±55.85μm；p = 0.271），而平均眼压为13.08±4.48mmHg。术后三个月，IOP降低与BMO-MRW变化显著相关（r = 0.453，p < 0.05）。三个月随访时视乳头周围RNFL厚度无变化（p > 0.16），后期随访时显著降低（p = 0.009）。
采用初步临时阻塞的PRESERFLO®微型分流器植入术导致BMO-MRW显著短暂增加。这种现象也称为视盘凹陷的结构逆转（SRDC）。与小梁切除术后具有可比术前和术后IOP水平的先前数据相比，这种效果似乎不太明显且持续时间较短。
