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Corneal endothelial cell density changes after Preserflo MicroShunt implantation
Taro Baba1, Osamu Baba1, Kikuno Hirose1
1Department of Ophthalmology and Visual Science, Hiroshima University, Hiroshima, Japan.
Aims:
To evaluate the effect of Preserflo MicroShunt (PMS) implantation on corneal endothelial cell density (CECD) and to identify factors associated with CECD loss.
Methods:
This retrospective study included patients who underwent PMS implantation, with or without combined cataract surgery, between March 2023 and April 2024, with a minimum of 12 months of postoperative follow-up. CECD was measured preoperatively and at 3, 6 and 12 months postoperatively. The primary outcome was the change in CECD after PMS implantation. Secondary analyses included linear regression to estimate annual CECD loss and logistic regression to identify factors associated with CECD reduction.
Results:
In total, 104 eyes (70 PMS alone, 34 combined with phacoemulsification) were included. Mean CECD (cells/mm²) in PMS-alone group and combined-with-phacoemulsification group were 2312.9±501.7 and 2615.0±365.5 at baseline, 2253.7±530.9 and 2354.4±424.6 at 3 months postoperatively, 2234.6±528.5 and 2374.6±458.9 at 6 months postoperatively and 2149.2±537.5 and 2357.6±508.7 at 12 months postoperatively, respectively. The estimated annual CECD loss was 7.3±11.9% in the PMS-alone group and 8.0±17.2% in the combined-with-phacoemulsification group (p=0.47). Multivariate logistic regression revealed that a narrower tube-cornea angle (TCA) (p=0.01) and higher preoperative IOP (p=0.04) were significantly associated with greater CECD loss.
Conclusions:
PMS implantation was associated with CECD reduction over 12 months. A narrower TCA and higher preoperative intraocular pressure were significant predictors of CECD loss.
Insights
Preserflo MicroShunt implantation led to a reduction in corneal endothelial cell density over 12 months. Narrower tube-cornea angles and higher preoperative intraocular pressure predicted this cell loss.
Area of Science:
- Ophthalmology
- Glaucoma Surgery
- Corneal Health
Background:
- Preserflo MicroShunt (PMS) is a device used in glaucoma surgery.
- Corneal endothelial cell density (CECD) is crucial for corneal transparency and function.
- Understanding the impact of glaucoma devices on CECD is important for patient outcomes.
Purpose of the Study:
- To evaluate the effect of Preserflo MicroShunt (PMS) implantation on corneal endothelial cell density (CECD).
- To identify factors associated with CECD loss after PMS implantation.
Main Methods:
- Retrospective study of 104 eyes undergoing PMS implantation (alone or with cataract surgery).
- CECD measured preoperatively and at 3, 6, and 12 months postoperatively.
- Linear and logistic regression used to analyze CECD change and associated factors.
Main Results:
- Annual CECD loss was estimated at 7.3% for PMS alone and 8.0% for combined surgery.
- A narrower tube-cornea angle (TCA) was significantly associated with greater CECD loss (p=0.01).
- Higher preoperative intraocular pressure (IOP) was also a significant predictor of CECD loss (p=0.04).
Conclusions:
- Preserflo MicroShunt implantation is associated with a reduction in CECD over 12 months.
- Narrower TCA and higher preoperative IOP are significant predictors of CECD loss following PMS implantation.
- These findings highlight the importance of considering pre-existing ocular conditions when evaluating patients for PMS implantation.
