Abstract
Purpose :
The Preserflo microshunt is a surgical implant designed to lower intraocular pressure (IOP) by directing aqueous from the anterior chamber to the subconjunctival space. Placing this microshunt in the anterior chamber poses a risk of hypotony in the early postoperative period, a common complication in drainage device procedures. This study introduces a novel surgical protocol involving routine intraluminal occlusive suture insertion to mitigate postoperative hypotony by impeding aqueous flow.
Methods :
In this non-comparative, prospective, and interventional study, 50 glaucoma patients underwent Preserflo implantation. A 10-0 prolene releasable suture was inserted 3 mm intraluminally into the distal lumen of the microshunt, thereby limiting aqueous outflow. IOP measurements and antiglaucoma drug (AGD) usage were recorded preoperatively and postoperatively on day 1, weekly for the first two months, and every three months thereafter. The criteria for postoperative intraluminal suture removal were IOP > 12 mmHg. IOP was also measured immediately after suture removal.
Results :
The median preoperative IOP was 19 (IQR 16-24) mmHg with a median use of 2.7 (IQR 1-4) AGD. The median postoperative IOP was 8 (IQR 7-10) mmHg at 1 week. Suture removal occurred at a median of 6 (IQR 4-8) weeks with a median IOP reduction of 2 (IQR 1-3) mmHg, resulting in a median IOP of 10 (IQR 9-11) mmHg. No cases of transient hypotony occurred after suture removal.
Conclusions :
The protocol effectively prevented hypotony complications and led to a safer and predictable reduction in intraocular pressure, highlighting the potential of this innovative approach in minimizing postoperative complications following microshunt surgery.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.