Grobshäuser Ellen, Cunha Vaz Martinho Antonio, Gatzioufas Zisis, Hasler Pascal, Maloca Peter, Gugleta Konstantin
Ophthalmology, Vista Augenklinik Binningen, Switzerland.
Ophthalmology Department, University Hospital Basel, Switzerland.
Klin Monbl Augenheilkd. 2025 Apr;242(4):392-397. doi: 10.1055/a-2495-8580. Epub 2025 Jan 27.
Loss of corneal endothelial cells after glaucoma surgery can lead to corneal decompensation and reduced vision. This loss may be accelerated by drainage implants like PreserFlo, which allow controlled subconjunctival filtration. In a retrospective analysis, we examined its impact on corneal endothelial cell density (ECD).
Data from medical records for 94 eyes were retrospectively analyzed. This included 47 PreserFlo-operated eyes and 47 contralateral control eyes. Inclusion criteria were open-angle glaucoma, laser trabeculoplasty as the only prior glaucoma surgery, and a contralateral control eye without any previous glaucoma surgeries and without any relevant diseases. Only standalone procedures and pseudophakic eyes were considered. We included 48 eyes at 2 weeks (24 operated, 24 control eyes), 72 at 3 months (36 each), 34 at 1 year (17 each), and 36 at 3 years (18 each).
Preoperatively, the 47 eyes that were planned for surgery had a mean ECD of 2141 ± 527 cells/mm², and the 47 control eyes had an ECD of 2114 ± 561 cells/mm². Two weeks postoperatively, ECD decreased by 5.4% in the operated eyes and increased by 1.1% in the control eyes. After 3 months, endothelial cell loss (ECL) was 3.6% (operated) and 1.9% (controls). After 1 year, ECL was 11.7% (operated) and 5.6% (controls); after 3 years it was 7.6% (operated) and 2.9% (controls). No significant differences in ECL dynamics between the operated and control eyes were detected by the analysis of variance.
Although there was a trend to accelerated ECL in operated eyes compared to controls, this difference was not significant. Overall, the Preserflo procedure appears safe as regards to its influence on endothelial cell count.
青光眼手术后角膜内皮细胞的丢失可导致角膜失代偿和视力下降。像PreserFlo这样的引流植入物可能会加速这种丢失，PreserFlo可实现可控的结膜下滤过。在一项回顾性分析中，我们研究了其对角膜内皮细胞密度（ECD）的影响。
对94只眼睛的病历数据进行回顾性分析。其中包括47只接受PreserFlo手术的眼睛和47只对侧对照眼。纳入标准为开角型青光眼、仅接受过激光小梁成形术作为既往青光眼手术，以及对侧对照眼未接受过任何青光眼手术且无任何相关疾病。仅考虑独立手术和人工晶状体眼。我们纳入了2周时的48只眼睛（手术眼24只，对照眼24只）、3个月时的72只眼睛（各36只）、1年时的34只眼睛（各17只）和3年时的36只眼睛（各18只）。
术前，计划手术的47只眼睛的平均ECD为2141±527个细胞/mm²，47只对照眼的ECD为2114±561个细胞/mm²。术后2周，手术眼的ECD下降了5.4%，对照眼增加了1.1%。3个月后，内皮细胞丢失（ECL）为3.6%（手术眼）和1.9%（对照眼）。1年后，ECL为11.7%（手术眼）和5.6%（对照眼）；3年后为7.6%（手术眼）和2.9%（对照眼）。通过方差分析未检测到手术眼和对照眼之间ECL动态的显著差异。
尽管与对照眼相比，手术眼的ECL有加速趋势，但这种差异并不显著。总体而言，Preserflo手术对内皮细胞计数的影响似乎是安全的。
