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Endothelial cell loss 5 years after Preserflo MicroShunt implantation: About two cases
Chloé Chamard1,2, Sirine Hammoud3, Elisa Bluwol3
1Department of Ophthalmology, Gui de Chauliac Hospital, Montpellier, F-34000, France.
Purpose:
Preserflo MicroShunt is a minimally-invasive glaucoma drainage micro-tube used to shunt aqueous humor from the anterior chamber to the subtenon space. The safety of the procedure was considered satisfactory with a majority of minor side effects.
Observation:
We describe the 5 year endothelial cell loss after Preserflo implantation in 2 primary open angle glaucoma patients. The case 1 presented a device-cornea touch after a backward migration of the device. The case 2 presented a modified aspect of the device compatible with an inflammatory reaction. Both cases were explanted.
Conclusion:
As described in Ahmed glaucoma valve, Xen gel stent and Cypass, Preserflo MicroShunt can lead to endothelial cell loss in some cases. A long-term prospective study with pre and postoperative endothelial cell count and AS-OCT or UBM evaluation of the device positioning would be of great interest to assess the real impact of Preserflo MicroShunt and risk factors for endothelial cell loss.
Insights
The Preserflo MicroShunt, a glaucoma drainage device, may cause endothelial cell loss in some patients, necessitating further long-term studies to assess risks and impact.
Area of Science:
- Ophthalmology
- Medical Devices
Background:
- Preserflo MicroShunt is a minimally-invasive glaucoma drainage device.
- It shunts aqueous humor from the anterior chamber to the subtenon space.
- Initial safety profile considered satisfactory with minor side effects.
Observation:
- This report details 5-year outcomes of Preserflo implantation in two primary open-angle glaucoma patients.
- Case 1: Device-cornea touch due to backward migration.
- Case 2: Device modification associated with inflammatory reaction.
Findings:
- Both patients required device explantation due to complications.
- Preserflo MicroShunt, similar to other glaucoma devices, can cause endothelial cell loss.
- Complications included device migration and inflammatory reactions.
Implications:
- Long-term prospective studies are needed to evaluate Preserflo MicroShunt's real-world impact.
- Assessing pre- and post-operative endothelial cell counts is crucial.
- Anterior segment OCT or ultrasound biomicroscopy can evaluate device positioning and identify risk factors for endothelial cell loss.
