Gadelkarim Inas, Jones Lee, Qidwai Umair, Ratnarajan Gokulan
Queen Victoria Hospital NHS Foundation Trust, Moorfields Eye Hospital NHS Foundation Trust, University College London, London, UK.
Ophthalmology Department, Alexandria University, Alexandria, Egypt.
Ther Adv Ophthalmol. 2025 Apr 21;17:25158414241287421. doi: 10.1177/25158414241287421. eCollection 2025 Jan-Dec.
The PRESERFLO Microshunt procedure offers a safe and effective alternative to trabeculectomy procedure. The adjuvant use of anti-vascular endothelial growth factor (VEGF) with trabeculectomy has been well studied, yet little is known on the effect and safety of anti-VEGF agents used as an adjunctive therapy in PRESERFLO procedures.
To compare the outcomes of PRESERFLO Microshunt procedure using either mitomycin C (MMC) alone versus MMC augmented with bevacizumab in patients with open angle glaucoma to a follow-up time of 6 months.
Retrospective observational single-center single-surgeon study.
Patients' records of patients who consecutively underwent PRESERFLO Microshunt at Queen Victoria Hospital, United Kingdom, were examined. From December 2018 to January 2020, eligible patients underwent PRESERFLO Microshunt implantation with MMC alone (0.2-0.4 mg/ml), whereas from February 2020 to January 2022, patients underwent PRESERFLO Microshunt implantation with MMC (0.2-0.4 mg/ml) and adjuvant intracameral 0.1 ml of bevacizumab (1.25 mg/0.05 ml). Efficacy outcomes were analyzed, including changes in intraocular pressure (IOP) and changes in medication use. Postoperative complications and postoperative interventions were also reviewed.
A total of 75 eyes were included in the analysis, 38 eyes received MMC alone, whereas 37 eyes received MMC combined with bevacizumab. There were no statistically significant differences in the demographic or clinical profile of patients between treatment groups.Both strategies were effective in terms of IOP lowering (baseline vs 6 months postoperatively: 20.0 (6.8) mmHg vs 12.8 (3.7) mmHg in the MMC group; 23.6 (6.9) mmHg vs 11.9 (4.2) mmHg in the MMC+ bevacizumab group; < 0.001 in both comparisons). Mean anti-glaucoma medication use also reduced significantly from baseline with no difference between both groups. A higher proportion of patients required postoperative interventions (5-FU injection, needling, and bleb revision) in the MMC alone group ( = 16; 42.1%) compared to the MMC+ bevacizumab group ( = 4; 9.9%) which was statistically significant (Pearson's χ test; = 0.002).
Adjuvant use of bevacizumab in MMC-augmented PRESERFLO Microshunt procedure is at least as effective as MMC alone but helps reduce rates of postoperative interventions.
PRESERFLO微型分流术为小梁切除术提供了一种安全有效的替代方案。抗血管内皮生长因子（VEGF）与小梁切除术联合使用已得到充分研究，但对于抗VEGF药物作为PRESERFLO手术辅助治疗的效果和安全性知之甚少。
比较在开角型青光眼患者中单独使用丝裂霉素C（MMC）与MMC联合贝伐单抗的PRESERFLO微型分流术至6个月随访期的结果。
回顾性观察性单中心单术者研究。
检查在英国维多利亚女王医院连续接受PRESERFLO微型分流术患者的记录。2018年12月至2020年1月，符合条件的患者单独接受含MMC（0.2 - 0.4mg/ml）的PRESERFLO微型分流植入术，而2020年2月至2022年1月，患者接受含MMC（0.2 - 0.4mg/ml）和辅助性前房内注射0.1ml贝伐单抗（1.25mg/0.05ml）的PRESERFLO微型分流植入术。分析疗效结果，包括眼压（IOP）变化和药物使用变化。还回顾了术后并发症和术后干预情况。
分析共纳入75只眼，38只眼单独接受MMC，37只眼接受MMC联合贝伐单抗。治疗组间患者的人口统计学或临床特征无统计学显著差异。两种策略在降低眼压方面均有效（MMC组基线眼压与术后6个月眼压：20.0（6.8）mmHg对12.8（3.7）mmHg；MMC + 贝伐单抗组：23.6（6.9）mmHg对11.9（4.2）mmHg；两组比较P均<0.001）。平均抗青光眼药物使用量也较基线显著减少，两组间无差异。单独使用MMC组需要术后干预（5 - FU注射、针刺和滤泡修复）的患者比例（n = 16；42.1%）高于MMC + 贝伐单抗组（n = 4；9.9%），差异有统计学意义（Pearson卡方检验；P = 0.002）。
在MMC增强的PRESERFLO微型分流术中辅助使用贝伐单抗至少与单独使用MMC一样有效，但有助于降低术后干预率。
