Efficacy and safety at 12 months of PRESERFLO® combined with DuraGen® and morphological evaluation using AS-OCT

To evaluate the efficacy and safety at 12 months of PRESERFLO® implantation combined with 0.04% MMC and the interposition of DuraGen® in patients with moderate or severe glaucoma, and to analyse bleb morphology using anterior segment optical coherence tomography (AS-OCT).

Prospective study including 50 eyes that underwent PRESERFLO® implantation with 0.04% MMC and DuraGen®, either as a standalone procedure or combined with cataract surgery. Complete success was defined as achieving an intraocular pressure (IOP) between 5 and 18 mmHg without topical hypotensive treatment, qualified success when this range was achieved with treatment, and failure when these criteria were not met. Postoperative complications and bleb morphology were assessed using AS-OCT. In addition, a comparative subanalysis between standalone and combined surgery was performed.

Mean preoperative IOP was 26.8 ± 7.1 mmHg and decreased to 13.1 ± 4.5 mmHg, representing a mean reduction of 47.9% (P < .001). Complete success was achieved in 42 eyes (84%), qualified success in 5 eyes (10%), and failure was observed in 3 eyes (6%). The most frequent complication was choroidal detachment (22%). No significant differences were observed between standalone and combined surgery regarding final IOP or surgical success rates. In successful cases, AS-OCT more frequently showed a suprascleral aqueous lake, whereas failed cases presented a flat bleb.

PRESERFLO® implantation combined with 0.04% MMC and DuraGen® was effective and safe for IOP control at 12 months. AS-OCT allows identification of morphological patterns associated with success and failure.