Yamae Teruki, Sakata Rei, Suzuki Haruyuki, Aoyama Yurika, Nemoto Hotaka, Saito Hitomi, Honjo Megumi, Shirato Shiroaki, Aihara Makoto
Department of Ophthalmology, Graduate of Medicine and Faculty of Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
Yotsuya Shirato Eye Clinic, Tokyo, Japan.
Jpn J Ophthalmol. 2025 Aug 26. doi: 10.1007/s10384-025-01265-5.
This study evaluated the efficacy and safety of initially implanted PreserFlo MicroShunt (PMS) in Japanese patients with exfoliation glaucoma (XFG). Using propensity score matching, intraocular pressure (IOP) control rates were compared between patients with XFG and primary open-angle glaucoma (POAG).
Retrospective observational study.
This study reviewed 31 eyes of 31 patients with XFG who underwent initial PMS implantation with mitomycin C. IOP, medication scores, and corneal endothelial cell density (CECD) were assessed preoperatively and at up to 6 months postoperatively. Kaplan-Meier analysis was used to estimate the 6-month survival rate, defined as an IOP reduction of > 20% from baseline and an IOP < 15 mmHg. The incidences of needling, reoperation, and complications were also assessed. IOP control was compared between XFG and propensity-score-matched POAG patients using the log-rank test.
At 6 months, the mean IOP had decreased significantly, from 22.3 ± 6.6 to 14.7 ± 6.6 mmHg, and the medication score had declined from 4.5 to 1.4. CECD decreased from 2127 to 1902 cells/mm, although this was not statistically significant. The complete success rate (without any glaucoma medications or intervention) was 48%. Postoperative complications included anterior chamber hemorrhage and choroidal detachment. Needling was performed in nine eyes (29.0%), and additional surgery was performed in five eyes (16.1%). Compared to POAG patients (11.9 mmHg), XFG patients had higher postoperative IOP (14.8 mmHg) and higher medication scores (0.5 vs 1.4, p = 0.04) and a lower success rate (62.2% vs 41.7%).
PMS in Japanese patients with XFG resulted in a significant IOP reduction over 6 months, with a relatively favorable safety profile. However, its efficacy was slightly inferior to that in POAG, implying potential differences in PMS responsiveness between glaucoma subtypes.
本研究评估了初次植入PreserFlo微分流器（PMS）对日本剥脱性青光眼（XFG）患者的疗效和安全性。采用倾向评分匹配法，比较了XFG患者和原发性开角型青光眼（POAG）患者的眼压（IOP）控制率。
回顾性观察研究。
本研究回顾了31例接受初次PMS植入联合丝裂霉素C治疗的XFG患者的31只眼睛。在术前及术后6个月内评估眼压、药物评分和角膜内皮细胞密度（CECD）。采用Kaplan-Meier分析评估6个月生存率，定义为眼压较基线降低>20%且眼压<15 mmHg。还评估了针刺、再次手术和并发症的发生率。采用对数秩检验比较XFG患者和倾向评分匹配的POAG患者的眼压控制情况。
6个月时，平均眼压显著降低，从22.3±6.6 mmHg降至14.7±6.6 mmHg，药物评分从4.5降至1.4。CECD从2127个细胞/mm降至1902个细胞/mm，尽管差异无统计学意义。完全成功率（无需任何青光眼药物或干预）为48%。术后并发症包括前房出血和脉络膜脱离。9只眼（29.0%）进行了针刺，5只眼（16.1%）进行了额外手术。与POAG患者（11.9 mmHg）相比，XFG患者术后眼压较高（14.8 mmHg），药物评分较高（0.5对1.4，p = 0.04），成功率较低（62.2%对41.7%）。
日本XFG患者植入PMS后6个月眼压显著降低，安全性相对良好。然而，其疗效略逊于POAG患者，这意味着青光眼亚型之间PMS反应性可能存在差异。
