Javier García-Bardera MD , Julian Garcia-Feijoo MD, PhD , Laura Morales-Fernández MD, PhD , Clara Heredia-Pastor MD , Álvaro Ponce-de-León MD , Mireia García-Bermúdez MD , Marco Antonio Pascual-Santiago MD , Bárbara Burgos-Blasco MD, PhD , Jose María Martínez-de-la-Casa MD, PhD , Julián Garcia-Sánchez MD, PhD
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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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