Gehrke Miranda, Keidel Leonie F, Buhl Lara, Priglinger Siegfried G, Mackert Marc J
Department of Ophthalmology, LMU University Hospital, LMU Munich, Mathildenstr. 8, 80336 Munich, Germany.
J Clin Med. 2025 Sep 3;14(17):6224. doi: 10.3390/jcm14176224.
Early postoperative hypotony and complications like choroidal detachment can occur after Preserflo MicroShunt (MS) implantation in patients with pseudoexfoliation glaucoma (PEXG). To prevent these risks, outflow from the microshunt tube can be reduced by implementing a nylon stent. This study aims to evaluate the impact of intraluminal stenting of the MS during the first four months after surgery. This retrospective study of 43 eyes investigated the incidence of intraocular hypotony in PEXG patients undergoing MS implantation with ( = 23) or without ( = 20) intraluminal stenting using a 10.0 nylon suture. The follow-up period was four months after surgery. Our results demonstrated that intraluminal stenting significantly reduced the incidence of postoperative complications related to hypotony. Notably, no cases of choroidal detachment occurred in the nylon-stenting group (nsMS) compared to 30% (6 eyes) in the MS-only group ( = 0.0064). The hypotony rates between the nsMS (21.74%, 5 eyes) and the MS-only group (40%, 8 eyes) did not significantly differ ( = 0.3184). Both groups experienced significant reductions in intraocular pressure ( < 0.001) and a decrease in the number of antiglaucomatous medications ( < 0.001) up to four months after surgery. The use of an intraluminal stent (10.0 nylon suture) during MS implantation may be a promising strategy to reduce the risk of hypotony-related complications, particularly choroidal detachment, in patients with PEXG.
在假性剥脱性青光眼（PEXG）患者中植入Preserflo微型分流器（MS）后，术后早期可能会出现低眼压以及脉络膜脱离等并发症。为预防这些风险，可通过植入尼龙支架来减少微型分流管的房水流出量。本研究旨在评估术后前四个月内在MS管腔内植入支架的影响。这项回顾性研究纳入了43只眼睛，调查了接受MS植入术的PEXG患者中，使用10.0尼龙缝线进行管腔内支架植入（n = 23）或未植入（n = 20）的患者发生眼内低眼压的情况。随访期为术后四个月。我们的结果表明，管腔内支架植入显著降低了与低眼压相关的术后并发症发生率。值得注意的是，尼龙支架植入组（nsMS）未发生脉络膜脱离病例，而单纯MS组的发生率为30%（6只眼）（P = 0.0064）。nsMS组（21.74%，5只眼）和单纯MS组（40%，8只眼）的低眼压发生率无显著差异（P = 0.3184）。两组患者在术后四个月内眼压均显著降低（P < 0.001），抗青光眼药物使用量也有所减少（P < 0.001）。在MS植入过程中使用管腔内支架（10.0尼龙缝线）可能是一种有前景的策略，可降低PEXG患者发生低眼压相关并发症尤其是脉络膜脱离的风险。
