Efficacy And Safety Of Stented Vs. Non-Stented Preserflo Michroshunt

To compare efficacy and safety of Preserflo Michroshunt (PMS) implantation with and without the insertion of 10-0 nylon suture as intraluminal stent.

I.R.C.C.S. Azienda Ospedaliero-Universitaria di Bologna, Ophthalmology Unit; Nuovo Ospedale Civile di Sassuolo; and Studio Oculistico D'Azeglio.

This was a retrospective multicentric study involving adult glaucoma patients undergoing 0.4 mg/mL MMC augmented PMS implantation with or without endoluminal 10-0 nylon suture. Congenital, juvenile and secondary glaucoma were excluded from the analysis.The decision to incorporate a 10-0 nylon intraluminal suture was at the discretion of each surgeon, patients were divided into two groups: non-stented PMS (nsPMS) and stented PMS (sPMS). Follow-up points were at 1, 7, 14, 21, 30, 60, 90, and 120 days from surgery. The study defined overall success as an intraocular pressure (IOP)>5 and ≤18 mmHg with a reduction of at least 20% at each follow-up point or after stent removal, achieving complete success without the need for glaucoma medications.

Charts from 140 eyes, 75 in the nsPMS and 65 in the sPMS group, were reviewed. Baseline characteristics were comparable between the two groups. The proportion of patients that achieved success was comparable (62.76±6.68% and 61.76±9.67% for overall success, 56.61±7.35% and 53.14±10.28% for complete success in nsPMS and sPMS groups at 120 days, respectively, p = 0.46 and p = 0.33, respectively). IOP differed significantly (p<0.000) only on postoperative days 1 and 7. Mean IOP at 120 days was not different between groups (p=0.64). Seventeen nsPMS and 5 sPMS patients developed numerical hypotony (p=0.019), and 16 and 3 patients experienced hypotony-related complications (HRCs) (p=0.005). Occurrence of other complications was comparable.

While the two groups revealed similar success rates, the study underscores the advantage of the stented PMS approach in mitigating the risk of hypotony and HRCs. These findings emphasize the potential benefits of incorporating a 10-0 nylon suture as an intraluminal stent during PMS implantation to minimize adverse events.