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Bleb geometry and morphology after Preserflo Microshunt surgery: Risk factors for surgical failure
Marta Ibarz Barberá1, Jose Luis Hernández-Verdejo2, Jean Bragard3
1Oftalvist Group, Moncloa HLA Hospital, Madrid, Spain.
Plos One
|June 8, 2023
Summary
Successful Preserflo Microshunt (PMS) implantation outcomes depend on bleb characteristics. Higher baseline intraocular pressure (IOP) is linked to better surgical success, with AS-OCT revealing key structural indicators.
Area of Science:
- Ophthalmology
- Glaucoma Surgery
- Medical Imaging
Background:
- Preserflo Microshunt (PMS) implantation is a surgical option for glaucoma management.
- Understanding factors influencing PMS treatment success is crucial for patient outcomes.
Purpose of the Study:
- To identify risk factors for treatment failure after Preserflo Microshunt (PMS) implantation.
- To analyze internal bleb structures using anterior-segment optical coherence tomography (AS-OCT).
Main Methods:
- AS-OCT evaluation of 54 PMS blebs.
- Mathematical modeling to calculate episcleral fluid cavity (EFC) total filtering surface (TFS) and bleb wall hydraulic conductivity (HC).
- Logistic regression analysis of baseline characteristics and bleb success (IOP 6-17 mmHg).
Main Results:
- 74% of patients achieved complete success; 26% failed.
- Higher bleb wall reflectivity (BWR) correlated with failure; higher bleb wall thickness (BWT) with success.
- Successful blebs had wider, shorter EFCs; higher TFS correlated negatively with IOP.
- Higher baseline IOP was associated with PMS success.
Conclusions:
- Successful PMS blebs exhibit either thick hyporeflective walls or wide, thin-walled filtering surfaces.
- Elevated baseline intraocular pressure (IOP) positively influences the likelihood of surgical success.
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