Abstract
Purpose :
Modern glaucoma surgery provides innovative methods to efficiently decrease intraocular pressure (IOP). Our study compares the safety and efficacy of Preserflo™ MicroShunt (PF) to trabeculectomy (TE) in reducing IOP in patients with primary open angle glaucoma (POAG).
Methods :
In our retrospective monocentric study conducted at Stadtspital Zurich, we analyzed data from TE (2020) and PF (2020-22) surgeries performed by two surgeons. Informed consent was obtained from all the patients included. The primary endpoint was IOP reduction without medication one year postoperatively. Secondary endpoints included best-corrected visual acuity (BCVA), postoperative complications, and the need for additional interventions. We used Linear mixed models (LMM) to analyze both groups in terms of the outcome parameters. The retreatment analysis was performed using Kaplan-Meier and Cox Proportional Hazard Models.
Results :
We included 210 eyes in our study (PF: 164 eyes, TE: 46 eyes). Demographics, such as age, gender, preoperative IOP and BCVA, revealed comparable profiles in both groups (p>0.05). In eyes with PF, we observed effective and early IOP reduction (p<0.001) already during the first months. The analysis of complications in the first month indicated a greater likelihood of ocular hypotony (≤5 mmHg) in the PF group (p=0.016) and a higher probability for additional treatment (i.e., needling, suturolysis, etc.) due to insufficient IOP reduction (p<0.001) after TE, as demonstrated by Kaplan-Meier (p=0.039) and Cox proportional hazard (HR=3.14 vs 1.98) Models.
Conclusions :
While both procedures demonstrate mid-term effectiveness over one year, PF seems to show better efficacy, especially in the short term. We plan an extended, retrospective, multicentric study to confirm these findings.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.