Endothelial Cell Density Impact Of Preserflo Microshunt Implant: A Prospective Study

The primary objective of this study is to assess endothelial cell density over time after Preserflo microshunt surgery. Additionally, the secondary objectives are to evaluate the reduction in intraocular pressure (IOP) and the decrease in topical hypotensive treatment after surgery, as well as the presence or absence of complications. 

Tertiary hospital of the National Healthy System

Prospective evaluation of 35 eyes from 34 patients who underwent Preserflo implant surgery between June of 2021 and July of 2023. Exclusion criteria included secondary glaucoma, combined surgeries, previous glaucoma surgery, cataract surgery in the last 12 months and endothelial cell density below 2000 cells/mm3. Endotelial cells density was measure using specular microscopy at various corneal positions (central, superior, temporal, temporal-superior, nasal superior and inferior) before surgery and 1, 3, 6 and 12 months postoperatively. Tube position and distance endothelial-tube were assessed using anterior segment optical coherence tomography.

A significant reduction in cell endothelial density was observed across all positions one year after surgery: 10.5% reduction in the central area (p = 0.004), 14,6% in the superior area (p < 0.001), 13% in temporal-superior area (p = 0.001), 10.62% in nasal-superior area (p 0.004) and 13,4% in inferior area (p < 0.001). The tube position was superior in 16 eyes, temporal in 14 and nasal in 4. No significant differences in endothelial cell density were observed based on tube position or the endothelial-tube distance (mean 519,1 ± 234,4 µm).