Page 128 - A Magyar Szemorvostársaság 2023. évi kongresszusa - Tudományos program és előadáskivonatok

Our short-term experiences with Preserflo microshunt (ab externo) implantation
György Bátor, Dorottya Kis, Mária Ferenczy, Péter Rend, András Zelkó, Beáta Rozmán,
Zsófia Kardos
Vas Vármegyei Markusovszky University Teaching Hospital, Szombathely

Introduction: Safety and efficacy of the Preserflo microshunt was examined in primary open
angle glaucoma and other diseases requiring elevated intraocular pressure reduction.

Patients and Method: Preserflo microshunt (ab externo) implantation was performed to reduce
intraocular pressure in 10 eyes of 10 patients, 6 with primary open-angle glaucoma, 2 with
primary closed-angle glaucoma, 1 with aniridia, 1 with essential iris atrophy. 3 patients required
surgical intervention due to allergic reaction to intraocular pressure lowering eye drops.

Pre- and post-operative intraocular pressures (IOP), eye drop use, best corrected visual acuity
(BCVA), complications of surgery were assessed. In all cases, the surgery was performed
under controlled conditions, according to the implantation protocol, with the administration of
0.5 mg/ml mitomycin for 2 minutes.

Results: Average age of the examined 1 male and 9 female patients was 59 years (30-78
years).

The mean intraocular pressure values decreased from 23.7 mm Hg preoperatively (range 14-
40 mm Hg) to 10.3 mm Hg (range 5-15 mm Hg) at 2 weeks postoperatively and to 9.8 mm Hg
(range 7-12 mm Hg) at 1 month.

No significant change was found in BCVA values compared to preoperative data (one case
with a decrease from 0.5 to 0.3), with a mean BCVA of 0.68 (light sensitivity - 1.0) before
surgery and 0.66 after surgery. Patients used an average of 4 (3-5) drug combinations for
intraocular pressure reduction in the preoperative period, in addition, 6 patients required per
os acetazolamide therapy (2x1 or 3x1 daily). After surgery, all patients were able to stop using
glaucomatous eye drops (antibiotic and steroid drops were left in all patients), and 1 patient
was temporarily treated with etamsilate and cyclopentolate-hydrochloride due to transient
vitreous haemorrhage.

As an intraoperative complication, 2 cases required a new channel. Postoperative
complications: 1 case of choroidal detachment (artephakic, closed angle, in a repeatedly
operated eye, resolved within 1 month), 3 cases of hyphaema (resolved within 2 weeks) and
2 cases of shallow anterior chamber (resolved within 2 weeks).

Conclusions: The reduction in mean IOP and glaucoma medication was significant and
sustained over the 1 month follow-up period. Final conclusions can be drawn with longer
follow-up and a larger number of cases. In the short term, preserflo microshunt implantation
proved to be an effective and safe surgical procedure in our patients.