Abstract
Purpose :
To compare the short-term complication rate and the need for additional surgical manipulation of a new subconjunctival Micro-shunt (MS) to Canaloplasty (CP) in eyes with open-angle glaucoma (OAG).
Methods :
Retrospective, interventional, comparative study. 50 eyes of 40 consecutive patients with OAG who had sub-conjunctival MS (PRESERFLO™ MicroShunt, Santen, Osaka, Japan) with 0.002% Mitomycin (MMC) were compared to a group of 50 eyes of 45 consecutive patients with OAG who underwent standard CP. Minimum follow-up for all cases was 6 months. Primary outcomes: Surgical time, intra- and early post-operative complication rate, number of subjects requiring additional surgical manipulations. Secondary outcome: Mean intraocular pressure (IOP) reduction at 6 months.
Results :
The mean surgical time was 18 min and 38 min for MS and VCP respectively. No intra-operative complication was recorded in either group. Most manipulations/revisions occurred in both groups within the first 6 months. Post-operative complication was not recorded in 22 and 30 eyes in the MS and CP group respectively. Needling was performed in 6 eyes in the MS group, 4 needed more than 2 needling with MMC. In the CP group one needling with MMC was performed in 2 eyes. Eight eyes in the MS group and 3 eyes in the CP group needed revision. Corneal decompensation occurred in 2 eyes in the MS group while Descemet membrane detachment occurred in 2 eyes in the CP group. Choroidal detachment occurred in 2 eyes in either group. Gonio-puncture was performed in 3 eyes for iris incarceration and in 5 eyes for high IOP in the CP group. MicroShunt extrusion and malignant glaucoma occurred each in two eyes in the MS group. Mean IOP reduction (± SD) at 6 months from baseline was 8.56 ± 7.30 mmHg and 9.93 ± 8.7 mmHg in MS and CP respectively.
Conclusions :
Use of the MS is a quick and relatively safe procedure. However as compared to CP, more invasive manipulation of the surgical site is required during the first 6 months in order to achieve target IOP. Both groups display a good IOP lowering effect at 6 months.
This is a 2020 ARVO Annual Meeting abstract.