The use of intraluminal PRESERFLO stenting in avoiding early postoperative hypotony.

Autor: Verma-Fuehring R; Department of Ophthalmology, University Hospital Würzburg (UKW), Josef-Schneider-Straße 11, 97080, Würzburg, Germany., Dakroub M; Department of Ophthalmology, University Hospital Würzburg (UKW), Josef-Schneider-Straße 11, 97080, Würzburg, Germany., Bamousa A; Department of Ophthalmology, University Hospital Würzburg (UKW), Josef-Schneider-Straße 11, 97080, Würzburg, Germany., Kann G; Department of Ophthalmology, University Hospital Würzburg (UKW), Josef-Schneider-Straße 11, 97080, Würzburg, Germany., Hillenkamp J; Department of Ophthalmology, University Hospital Würzburg (UKW), Josef-Schneider-Straße 11, 97080, Würzburg, Germany., Kampik D; Department of Ophthalmology, University Hospital Würzburg (UKW), Josef-Schneider-Straße 11, 97080, Würzburg, Germany. kampik_d@ukw.de.
Jazyk: angličtina
Zdroj: Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie [Graefes Arch Clin Exp Ophthalmol] 2024 Dec; Vol. 262 (12), pp. 3925-3932. Date of Electronic Publication: 2024 Jul 06.
DOI: 10.1007/s00417-024-06567-x
Abstrakt: Purpose: Postoperative hypotony following PRESERFLO MicroShunt (PMS) implantation is a frequent cause of complications such as choroidal detachment and hypotony maculopathy. This study aims at evaluating the impact of intraluminal stenting of the PMS during the early postoperative period.
Methods: We retrospectively analyzed the data of 97 patients who underwent PMS implantation with intraoperative placement of a Nylon 10-0 suture as intraluminal stent (PStent) and compared the outcomes to those of an existing database of the traditional MicroShunt implantation technique (PTrad, n = 120). The primary outcome measure was the intraocular pressure (IOP) at one week postoperatively. As a secondary outcome measure, adverse hypotony, defined as an IOP ≤ 5 mmHg with significant choroidal effusion and/or anterior chamber shallowing or the presence of macular folds was also assessed. Additionally, the time to stent removal and the IOP one week after stent removal were reported.
Results: Preoperative median IOP was 25.0 (20.5-30.3) mmHg in PStent and 25.0 (19.3-32.0) mmHg in PTrad (p = 0.62). One week after surgery, the median IOP dropped to 10.0 (8.0-13.0) mmHg in PStent and 7.0 (5.0-9.0) in PTrad (p < 0.01). At one month, the IOP was 12.0 (10.0-14.0) mmHg in PStent and 10.0 (8.0-11.0) mmHg in PTrad (p < 0.01). After 3 months, both groups showed similar median IOP levels of 11.0 (8.0-13.5) mmHg and 10.0 (9.75-13.0) mmHg in PStent and PTrad, respectively (p = 0.66). The presence of adverse hypotony was significantly lower in PStent compared to PTrad (6.2% vs 15.8%, p < 0.05). In PStent the stent was removed after 30.0 (21.0-42.5) days. One week after stent removal the mean IOP drop was 6.1 ± 0.5 mmHg (p < 0.01).
Conclusion: In the early follow-up period, intraluminal stenting of the PMS appears to be safe and effective in controlling the IOP while reducing early postoperative hypotony. Surgical success is not compromised by stent placement. Based on our data, it is recommended to remove the suture two to six weeks after surgery for most patients with uncomplicated postoperative clinical findings.
Competing Interests: Declarations. Ethics approval: Approval was obtained from the Institutional Review Board (IRB) of the University of Würzburg. The study adhered to the principles stated in the Declaration of Helsinki. Informed consent: In Germany informed consent is not required for retrospective studies. Conflict of interest: All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.
(© 2024. The Author(s).)
Databáze: MEDLINE
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