Javier García-Bardera, Julian Garcia-Feijoo, Laura Morales-Fernández, Clara Heredia-Pastor, Álvaro Ponce-de-León, Mireia García-Bermúdez, Marco Antonio Pascual-Santiago, Bárbara Burgos-Blasco, Jose María Martínez-de-la-Casa, Julián Garcia-Sánchez
{"title":"Outcomes of Preserflo MicroShunt Implantation in Refractory Childhood Glaucoma Following Ahmed Glaucoma Valve Surgery.","authors":"Javier García-Bardera, Julian Garcia-Feijoo, Laura Morales-Fernández, Clara Heredia-Pastor, Álvaro Ponce-de-León, Mireia García-Bermúdez, Marco Antonio Pascual-Santiago, Bárbara Burgos-Blasco, Jose María Martínez-de-la-Casa, Julián Garcia-Sánchez","doi":"10.1016/j.ogla.2025.04.011","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the clinical outcomes of Preserflo MicroShunt (PMS) implantation with mitomycin C (MMC) in managing refractory childhood glaucoma previously treated with Ahmed glaucoma valve (AGV).</p><p><strong>Design: </strong>A single-arm retrospective cohort study.</p><p><strong>Participants: </strong>Twenty-three eyes of 22 patients with refractory childhood glaucoma and a history of AGV implantation.</p><p><strong>Methods: </strong>All patients underwent PMS implantation with intraoperative MMC (0.04% for 2.5 minutes). Primary endpoints included intraocular pressure (IOP) reduction, reduction in antiglaucomatous medications, and surgical success. \"Complete success\" was defined as achieving target IOP without medications; \"qualified success\" allowed for medications. Safety parameters included intraoperative and postoperative complications and the need for further interventions.</p><p><strong>Main outcome measures: </strong>Intraocular pressure reduction, antiglaucomatous medication reduction, and surgical success rates.</p><p><strong>Results: </strong>Median follow-up was 23 months (interquartile range: 18-41). Mean baseline IOP was 27.0 ± 4.3 mmHg with 3.2 ± 0.5 medications. At 1 year, IOP decreased to 14.1 ± 4.4 mmHg (-47.0%) with 0.4 ± 1.0 medications and to 16.9 ± 3.6 mmHg (-40.2%) with 1.2 ± 1.5 medications at 2 years. Overall success rates for ≥20% IOP reduction were 91.3% at 1 year (69.9% complete success) and 72.7% at 2 years (45.5% complete success); for ≥30% reduction, they were 82.6% and 63.6%, respectively. During follow-up, 1 case of device extrusion was observed at 3 months, and another required surgical revision at 5 months.</p><p><strong>Conclusions: </strong>Preserflo MicroShunt implantation with MMC offers a valuable surgical option for managing refractory childhood glaucoma after AGV. The procedure achieved substantial reductions in both IOP and medication burden. Larger studies with extended follow-up are recommended to confirm its long-term efficacy.</p><p><strong>Financial disclosure(s): </strong>The author(s) have no proprietary or commercial interest in any materials discussed in this article.</p>","PeriodicalId":56368,"journal":{"name":"Ophthalmology. Glaucoma","volume":" ","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Ophthalmology. Glaucoma","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1016/j.ogla.2025.04.011","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: To evaluate the clinical outcomes of Preserflo MicroShunt (PMS) implantation with mitomycin C (MMC) in managing refractory childhood glaucoma previously treated with Ahmed glaucoma valve (AGV).
Design: A single-arm retrospective cohort study.
Participants: Twenty-three eyes of 22 patients with refractory childhood glaucoma and a history of AGV implantation.
Methods: All patients underwent PMS implantation with intraoperative MMC (0.04% for 2.5 minutes). Primary endpoints included intraocular pressure (IOP) reduction, reduction in antiglaucomatous medications, and surgical success. "Complete success" was defined as achieving target IOP without medications; "qualified success" allowed for medications. Safety parameters included intraoperative and postoperative complications and the need for further interventions.
Main outcome measures: Intraocular pressure reduction, antiglaucomatous medication reduction, and surgical success rates.
Results: Median follow-up was 23 months (interquartile range: 18-41). Mean baseline IOP was 27.0 ± 4.3 mmHg with 3.2 ± 0.5 medications. At 1 year, IOP decreased to 14.1 ± 4.4 mmHg (-47.0%) with 0.4 ± 1.0 medications and to 16.9 ± 3.6 mmHg (-40.2%) with 1.2 ± 1.5 medications at 2 years. Overall success rates for ≥20% IOP reduction were 91.3% at 1 year (69.9% complete success) and 72.7% at 2 years (45.5% complete success); for ≥30% reduction, they were 82.6% and 63.6%, respectively. During follow-up, 1 case of device extrusion was observed at 3 months, and another required surgical revision at 5 months.
Conclusions: Preserflo MicroShunt implantation with MMC offers a valuable surgical option for managing refractory childhood glaucoma after AGV. The procedure achieved substantial reductions in both IOP and medication burden. Larger studies with extended follow-up are recommended to confirm its long-term efficacy.
Financial disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.
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