Inas Gadelkarim, Lee Jones, Umair Qidwai, Gokulan Ratnarajan
{"title":"PRESERFLO®微分流术单独使用丝裂霉素C与使用丝裂霉素C和贝伐单抗的临床结果","authors":"Inas Gadelkarim, Lee Jones, Umair Qidwai, Gokulan Ratnarajan","doi":"10.1177/25158414241287421","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The PRESERFLO<sup>®</sup> Microshunt procedure offers a safe and effective alternative to trabeculectomy procedure. The adjuvant use of anti-vascular endothelial growth factor (VEGF) with trabeculectomy has been well studied, yet little is known on the effect and safety of anti-VEGF agents used as an adjunctive therapy in PRESERFLO<sup>®</sup> procedures.</p><p><strong>Objectives: </strong>To compare the outcomes of PRESERFLO Microshunt procedure using either mitomycin C (MMC) alone versus MMC augmented with bevacizumab in patients with open angle glaucoma to a follow-up time of 6 months.</p><p><strong>Design: </strong>Retrospective observational single-center single-surgeon study.</p><p><strong>Methods: </strong>Patients' records of patients who consecutively underwent PRESERFLO Microshunt at Queen Victoria Hospital, United Kingdom, were examined. From December 2018 to January 2020, eligible patients underwent PRESERFLO Microshunt implantation with MMC alone (0.2-0.4 mg/ml), whereas from February 2020 to January 2022, patients underwent PRESERFLO Microshunt implantation with MMC (0.2-0.4 mg/ml) and adjuvant intracameral 0.1 ml of bevacizumab (1.25 mg/0.05 ml). Efficacy outcomes were analyzed, including changes in intraocular pressure (IOP) and changes in medication use. Postoperative complications and postoperative interventions were also reviewed.</p><p><strong>Results: </strong>A total of 75 eyes were included in the analysis, 38 eyes received MMC alone, whereas 37 eyes received MMC combined with bevacizumab. There were no statistically significant differences in the demographic or clinical profile of patients between treatment groups.Both strategies were effective in terms of IOP lowering (baseline vs 6 months postoperatively: 20.0 (6.8) mmHg vs 12.8 (3.7) mmHg in the MMC group; 23.6 (6.9) mmHg vs 11.9 (4.2) mmHg in the MMC+ bevacizumab group; <i>p</i> < 0.001 in both comparisons). Mean anti-glaucoma medication use also reduced significantly from baseline with no difference between both groups. A higher proportion of patients required postoperative interventions (5-FU injection, needling, and bleb revision) in the MMC alone group (<i>N</i> = 16; 42.1%) compared to the MMC+ bevacizumab group (<i>N</i> = 4; 9.9%) which was statistically significant (Pearson's χ<sup>2</sup> test; <i>p</i> = 0.002).</p><p><strong>Conclusions: </strong>Adjuvant use of bevacizumab in MMC-augmented PRESERFLO Microshunt procedure is at least as effective as MMC alone but helps reduce rates of postoperative interventions.</p>","PeriodicalId":23054,"journal":{"name":"Therapeutic Advances in Ophthalmology","volume":"17 ","pages":"25158414241287421"},"PeriodicalIF":2.3000,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12033595/pdf/","citationCount":"0","resultStr":"{\"title\":\"Clinical outcomes of PRESERFLO<sup>®</sup> Microshunt procedure with mitomycin C alone versus with mitomycin C and bevacizumab.\",\"authors\":\"Inas Gadelkarim, Lee Jones, Umair Qidwai, Gokulan Ratnarajan\",\"doi\":\"10.1177/25158414241287421\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The PRESERFLO<sup>®</sup> Microshunt procedure offers a safe and effective alternative to trabeculectomy procedure. The adjuvant use of anti-vascular endothelial growth factor (VEGF) with trabeculectomy has been well studied, yet little is known on the effect and safety of anti-VEGF agents used as an adjunctive therapy in PRESERFLO<sup>®</sup> procedures.</p><p><strong>Objectives: </strong>To compare the outcomes of PRESERFLO Microshunt procedure using either mitomycin C (MMC) alone versus MMC augmented with bevacizumab in patients with open angle glaucoma to a follow-up time of 6 months.</p><p><strong>Design: </strong>Retrospective observational single-center single-surgeon study.</p><p><strong>Methods: </strong>Patients' records of patients who consecutively underwent PRESERFLO Microshunt at Queen Victoria Hospital, United Kingdom, were examined. From December 2018 to January 2020, eligible patients underwent PRESERFLO Microshunt implantation with MMC alone (0.2-0.4 mg/ml), whereas from February 2020 to January 2022, patients underwent PRESERFLO Microshunt implantation with MMC (0.2-0.4 mg/ml) and adjuvant intracameral 0.1 ml of bevacizumab (1.25 mg/0.05 ml). Efficacy outcomes were analyzed, including changes in intraocular pressure (IOP) and changes in medication use. Postoperative complications and postoperative interventions were also reviewed.</p><p><strong>Results: </strong>A total of 75 eyes were included in the analysis, 38 eyes received MMC alone, whereas 37 eyes received MMC combined with bevacizumab. There were no statistically significant differences in the demographic or clinical profile of patients between treatment groups.Both strategies were effective in terms of IOP lowering (baseline vs 6 months postoperatively: 20.0 (6.8) mmHg vs 12.8 (3.7) mmHg in the MMC group; 23.6 (6.9) mmHg vs 11.9 (4.2) mmHg in the MMC+ bevacizumab group; <i>p</i> < 0.001 in both comparisons). Mean anti-glaucoma medication use also reduced significantly from baseline with no difference between both groups. A higher proportion of patients required postoperative interventions (5-FU injection, needling, and bleb revision) in the MMC alone group (<i>N</i> = 16; 42.1%) compared to the MMC+ bevacizumab group (<i>N</i> = 4; 9.9%) which was statistically significant (Pearson's χ<sup>2</sup> test; <i>p</i> = 0.002).</p><p><strong>Conclusions: </strong>Adjuvant use of bevacizumab in MMC-augmented PRESERFLO Microshunt procedure is at least as effective as MMC alone but helps reduce rates of postoperative interventions.</p>\",\"PeriodicalId\":23054,\"journal\":{\"name\":\"Therapeutic Advances in Ophthalmology\",\"volume\":\"17 \",\"pages\":\"25158414241287421\"},\"PeriodicalIF\":2.3000,\"publicationDate\":\"2025-04-21\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12033595/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Therapeutic Advances in Ophthalmology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1177/25158414241287421\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"OPHTHALMOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Therapeutic Advances in Ophthalmology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/25158414241287421","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
背景：PRESERFLO®微分流手术是小梁切除术的一种安全有效的替代方法。抗血管内皮生长因子（VEGF）在小梁切除术中的辅助应用已经得到了很好的研究，但在PRESERFLO®手术中，抗VEGF药物作为辅助治疗的效果和安全性知之甚少。目的：比较PRESERFLO微分流术单独使用丝裂霉素C （MMC）与MMC增强贝伐单抗治疗开角型青光眼患者的结果，随访时间为6个月。设计：回顾性观察性单中心单外科医生研究。方法：对在英国维多利亚女王医院连续行PRESERFLO微分流术的患者资料进行分析。2018年12月至2020年1月，符合条件的患者接受了PRESERFLO Microshunt植入，单独使用MMC (0.2-0.4 mg/ml)，而2020年2月至2022年1月，患者接受了PRESERFLO Microshunt植入，同时使用MMC （0.2-0.4 mg/ml）和贝伐单抗（辅助0.1 ml）腹腔内（1.25 mg/0.05 ml）。对疗效结果进行分析，包括眼压（IOP）的变化和药物使用的变化。术后并发症和术后干预措施也进行了回顾。结果：共纳入75只眼，MMC单独治疗38只眼，MMC联合贝伐单抗治疗37只眼。治疗组之间患者的人口学或临床概况没有统计学上的显著差异。两种策略在降低IOP方面都是有效的(基线vs术后6个月：MMC组20.0 (6.8)mmHg vs 12.8 (3.7) mmHg；MMC+贝伐单抗组23.6 (6.9)mmHg vs 11.9 (4.2) mmHg；p N = 16；42.1%)与MMC+贝伐单抗组相比(N = 4；9.9%)，差异有统计学意义(Pearson χ2检验；p = 0.002)。结论：在MMC增强PRESERFLO微分流手术中辅助使用贝伐单抗至少与单独使用MMC一样有效，但有助于降低术后干预率。
Clinical outcomes of PRESERFLO® Microshunt procedure with mitomycin C alone versus with mitomycin C and bevacizumab.
Background: The PRESERFLO® Microshunt procedure offers a safe and effective alternative to trabeculectomy procedure. The adjuvant use of anti-vascular endothelial growth factor (VEGF) with trabeculectomy has been well studied, yet little is known on the effect and safety of anti-VEGF agents used as an adjunctive therapy in PRESERFLO® procedures.
Objectives: To compare the outcomes of PRESERFLO Microshunt procedure using either mitomycin C (MMC) alone versus MMC augmented with bevacizumab in patients with open angle glaucoma to a follow-up time of 6 months.
Methods: Patients' records of patients who consecutively underwent PRESERFLO Microshunt at Queen Victoria Hospital, United Kingdom, were examined. From December 2018 to January 2020, eligible patients underwent PRESERFLO Microshunt implantation with MMC alone (0.2-0.4 mg/ml), whereas from February 2020 to January 2022, patients underwent PRESERFLO Microshunt implantation with MMC (0.2-0.4 mg/ml) and adjuvant intracameral 0.1 ml of bevacizumab (1.25 mg/0.05 ml). Efficacy outcomes were analyzed, including changes in intraocular pressure (IOP) and changes in medication use. Postoperative complications and postoperative interventions were also reviewed.
Results: A total of 75 eyes were included in the analysis, 38 eyes received MMC alone, whereas 37 eyes received MMC combined with bevacizumab. There were no statistically significant differences in the demographic or clinical profile of patients between treatment groups.Both strategies were effective in terms of IOP lowering (baseline vs 6 months postoperatively: 20.0 (6.8) mmHg vs 12.8 (3.7) mmHg in the MMC group; 23.6 (6.9) mmHg vs 11.9 (4.2) mmHg in the MMC+ bevacizumab group; p < 0.001 in both comparisons). Mean anti-glaucoma medication use also reduced significantly from baseline with no difference between both groups. A higher proportion of patients required postoperative interventions (5-FU injection, needling, and bleb revision) in the MMC alone group (N = 16; 42.1%) compared to the MMC+ bevacizumab group (N = 4; 9.9%) which was statistically significant (Pearson's χ2 test; p = 0.002).
Conclusions: Adjuvant use of bevacizumab in MMC-augmented PRESERFLO Microshunt procedure is at least as effective as MMC alone but helps reduce rates of postoperative interventions.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
