Preserflo MicroShunt: Efficacy and Endothelial Cell Density

Abstract

Précis: A main safety concern associated with new glaucoma implants is corneal endothelial cell loss, which could even be observed in already established procedures. Purpose: The purpose of this study was to evaluate the efficacy and corneal safety, especially corneal endothelial cell loss (ECL), after Preserflo MicroShunt implantation. Methods: A monocentric, prospective clinical observational study of patients with a follow-up of at least 12 months who underwent Preserflo MicroShunt implantation at the Department of Ophthalmology, University Hospital of Düsseldorf, Germany, between January 2020 and October 2021. Endothelial cell density (ECD), the distance between the tip of the implant and the corneal endothelium, and the success of the surgery were analyzed. Results: In total, 14 eyes of 12 patients were included. After a mean follow-up of 20±2.7 months intraocular pressure was significantly reduced by 8.2 mm Hg (P=0.0041); in 28.6% of patients, a revision surgery was necessary. Reduction of preoperative and follow-up ECD was not statistically significant (ECL of 45 cells/mm2, ECDpreoperative=2074±703.6 cells/mm2, ECDlast follow-up=2029±742.3 cells/mm2, P=0.42). A longer intracameral shunt tube length correlated significantly with a higher distance between the shunt tip and corneal endothelium (r=0.61, P=0.036). Conclusions: Preserflo MicroShunt effectively lowered intraocular pressure without substantial ECL after a minimum follow-up period of 17 months.

Intermediate-term impact on corneal endothelial cells and efficacy of Preserflo MicroShunt implantation in patients with open-angle glaucoma – a prospective study over two years

“…Similarly, Qidwai et al [17] found no significant ECL over a 24-month study period; however, endothelial cell counts were available for only 12 of 48 patients. Furthermore, studies by Jamke et al [18] and by Steindor et al [19] found no significant ECL 12 months after PMS implantation. Notably, however, the current study is the only one investigating the impact of the PMS on the corneal endothelium with a follow-up period of at least 2 years.…”

Clinical Results of the MINIject Implant for Suprachoroidal Drainage

“…In a post hoc analysis of 5-year data for Hydrus, CyPass, and iStent inject procedures compared to phakoemulsification alone, it could be shown that the iStent had the lowest impact on ECD with the Hydrus and CyPass implants showing higher (and, in case of CyPass, accelerating) ECD loss [24]. The Preserflo MicroShunt implant similarly showed some ECD loss in most studies, with the position of the inflow end in relation to the corneal endothelium being of particular importance [25,26].…”