Fibrin Glue for Sutureless PreserFlo Surgery: A Case Series

Area of Science:

• Ophthalmology
• Glaucoma Surgery
• Minimally Invasive Glaucoma Surgery (MIGS)

Background:

• Advanced glaucoma requires effective intraocular pressure (IOP) management.
• Traditional glaucoma surgeries can involve complex procedures and potential complications.
• Sutureless techniques offer potential advantages in reducing surgical burden and recovery time.

Purpose of the Study:

• To evaluate the efficacy of sutureless PreserFlo MicroShunt insertion with fibrin glue for conjunctival closure and scleral band fixation.
• To assess IOP reduction, medication decrease, and complication rates in patients with advanced glaucoma.
• To determine the success rate defined as >20% IOP reduction at six months.

Main Methods:

• A retrospective case series of seven patients undergoing urgent PreserFlo MicroShunt insertion at Cairns Hospital.
• VeraSeal fibrin glue was used for conjunctival closure; scleral band fixation was employed in three cases.
• Pre- and post-operative IOP, visual acuity, and medication use were measured; complications and revision surgery needs were secondary outcomes.

Main Results:

• Mean IOP decreased significantly from 34.9±16.5 mmHg to 11.3±3.8 mmHg at six months.
• Glaucoma medication use reduced from a mean of 3.3 to 0.1.
• Complications included transient hypotony, tube exposure, and macrohyphema; no fibrin glue-related complications occurred. Scleral band fixation cases showed well-formed blebs.

Conclusions:

• Sutureless PreserFlo MicroShunt with fibrin glue and scleral band fixation is an effective method for reducing IOP and medication use in advanced glaucoma.
• The technique demonstrated minimal complications and a favorable follow-up profile.
• Further research is warranted to validate this sutureless approach in a larger patient cohort.