Anterior-Segment Optical Coherence Tomography Imaging of Patients Undergoing Supraciliary Glaucoma Drainage Device Implantation.

Abstract

Introduction: To evaluate anatomical changes after implantation of a novel supraciliary minimally invasive glaucoma drainage device using swept-source anterior segment optical coherence tomography (AS-OCT).

Methods: Monocentric prospective interventional case series. Forty-eight eyes with open-angle glaucoma underwent standalone or combined MINIject (MJ) implantation and were imaged postoperatively using AS-OCT at 1 week, 1 month, 3 months, and 6 months. Implant depth (D), implant position (O), cleft width (CW) in Circumferential Lake (CL) or Cleft Angle (CA), the amount of suprachoroidal fluid (SCF), and number of quadrants with visible SCF were assessed.

Results: Following MJ implantation, intraocular pressure (IOP) significantly decreased from 22.5 ± 9.0 mmHg to 14.1 ± 6.4 mmHg (p < 0.001) at 6 months, with concurrent reduction in ocular hypotensive medications from 2.4 ± 1.2 to 0.4 ± 0.9 (p < 0.001). SCF grading decreased from 3.1 ± 1.0 on day 1 to 1.5 ± 1.1 at 6 months (p < 0.001). Cleft width grade measured in length (CL) remained stable from 3.3 ± 0.9 to 3.2 ± 0.6 (p = 0.8), and arc-angle(CA) decreased from 35.9 ± 8.8 to 30.2 ± 7.1 degrees at 6 months (p = 0.07). The number of quadrants with visible SCF decreased from 3.7 ± 0.8 to 2.2 ± 1.6 (p < 0.001). Implant depth and orientation remained stable, with 45.5% of implants anterior, 33.3% at Schwalbe's line, and 21.2% behind it. Implant orientation varied, with 13.0% touching the iris, 69.6% pointing toward the anterior chamber, and 17.4% directed at the cornea.

Conclusions: AS-OCT is a noninvasive tool for imaging the supraciliary and suprachoroidal space after MINIject implantation. Over 6 months, we found a gradual decrease in the amount of SCF drainage and the number of quadrants with visible SCF. Cleft width remained stable and was not statistically associated with IOP lowering.