PreserFlo™ MicroShunt Combined with Phacoemulsification Versus PreserFlo™ MicroShunt As a Standalone Procedure in Patients with Medically Resistant Open-Angle Glaucoma

Overview

Journal J Curr Ophthalmol

Date 2022 Sep 23

PMID 36147269

Authors

Sofia Fili

Kalliopi Kontopoulou

Iraklis Vastardis

Georgios Perdikakis

Nikolaos Bechrakis

Markus Kohlhaas

Affiliations

Soon will be listed here.

Abstract

Purpose: To compare the efficacy and safety of PreserFlo™ MicroShunt (Santen, Osaka, Japan) combined with phacoemulsification to PreserFlo™ MicroShunt as a standalone procedure in eyes with moderate to advanced open-angle glaucoma.

Methods: In an observatory, prospective, clinical study, 30 patients (30 eyes) with moderate to advanced angle glaucoma were allocated to either PreserFlo™ MicroShunt combined with phacoemulsification (15 eyes; Group A) or PreserFlo™ MicroShunt as a standalone procedure (15 eyes; Group B). The follow-up time of the study was 12 months.

Results: Average intraocular pressure (IOP) at 12 months was 11.62 ± 1.6 mmHg in Group A and 13.8 ± 3.6 mmHg in Group B, which was significantly lower than baseline IOP (Group A: 23.47 ± 8.99 mmHg, < 0.001; Group B: 23.4 ± 8.68 mmHg, < 0.001). The absolute reduction of IOP within the 12 postoperative months was not significantly different between the two groups ( = 0.056). The number of the topical medications that were administered 12 months after ocular surgery was 0 in Group A and 0.6 ± 0.8 in Group B, compared to 3.13 ± 1.02 in Group A ( < 0.001) and 2.4 ± 1.45 in Group B ( = 0.004) at baseline. Phacoemulsification combined with PreserFlo™ MicroShunt significantly reduced the number of antiglaucoma agents after 12 months compared to the standalone procedure ( = 0.026). One eye in Group A was referred for bleb revision due to bleb fibrosis and a consequent acute postoperative rise in IOP. One eye in Group A required transscleral cyclophotocoagulation with MicroPulse laser. One bleb revision was also necessary in Group B at the 4 postoperative week. Endothelial cell density did not significantly change over 12 months in either group (Group A: baseline, 2017.3 ± 346.8 cells/mm; 12 months, 1968.5 ± 385.6 cells/mm; = 0.38; Group B: baseline, 2134.1 ± 382.6 cells/mm; 12 months, 2094.4 ± 373.3 cells/mm, = 0.42). The PreserFlo™ MicroShunt combined with phacoemulsification produced higher absolute success rates after 12 months in patients with moderate to advanced open-angle glaucoma than the PreserFlo™ MicroShunt as standalone procedure (Group A: 80% and Group B: 60%, = 0.022).

Conclusions: In eyes with moderate to advanced open-angle glaucoma, PreserFlo™ MicroShunt with or without phacoemulsification is effective in reducing IOP and the number of the antiglaucoma agents with a very small incidence of complications and subsequent glaucoma surgeries. However, adding phacoemulsification to PreserFlo™ MicroShunt successfully reduces IOP without the need for ongoing topical medications as are needed after the standalone procedure.

Citing Articles

Short-term efficacy and safety of PreserFlo MicroShunt in Japanese patients with medically treated primary open-angle glaucoma.

Suzuki H, Sakata R, Yamae T, Ishiyama Y, Sugimoto K, Saito H Jpn J Ophthalmol. 2025; .

PMID: 39826074 DOI: 10.1007/s10384-024-01159-y.

Preserflo MicroShunt Implantation: A Narrative Review of Its Standalone Benefits vs. Combined Use with Phacoemulsification in Managing Open-Angle Glaucoma.

Chilmonczyk M, Golaszewska K, Saeed E, Konopinska J Ophthalmol Ther. 2024; 14(1):41-54.

PMID: 39636489 PMC: 11724813. DOI: 10.1007/s40123-024-01068-w.

PreserFlo™ MicroShunt Versus Ab Externo Canaloplasty in Patients With Moderate to Advanced Open-Angle Glaucoma: 12-Month Follow-Up of a Single-Center Retrospective Study.

Habbe K, Kohlhaas M, Fili S Cureus. 2023; 15(2):e35185.

PMID: 36960244 PMC: 10030049. DOI: 10.7759/cureus.35185.

The PreserFlo MicroShunt in the Context of Minimally Invasive Glaucoma Surgery: A Narrative Review.

Saeed E, Golaszewska K, Dmuchowska D, Zalewska R, Konopinska J Int J Environ Res Public Health. 2023; 20(4).

PMID: 36833599 PMC: 9957246. DOI: 10.3390/ijerph20042904.

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