Corneal and Scleral Patch Graft Utilization in PreserFlo Microshunt with Ripcord versus PreserFlo Microshunt alone; Retrospective Review with 6 month Follow Up in a Canadian Centre

Theme: Glaucoma
What: Glaucoma
Part of: Glaucoma II: Surgery / Glaucome II: Chirurgical
When: 5/31/2024, 02:00 PM - 03:30 PM
Where: Room | Salle 801

Abstract

Purpose: The study compares the efficacy and safety of PreserFlo with donor sclera/corneal patch graft and ripcord versus PreserFlo alone.

Study Design: Retrospective chart review of cases with 6months follow up data available. 

Methods: 97 eyes were treated with either PreserFlo. Primary PreserFlo without a patch graft or ripcord was placed in 70 eyes. In 27 eyes a scleral or corneal patch graft was placed with a ripcord. The efficacy was evaluated by reduction of intraocular pressure (IOP) and glaucoma medication usage at 12 months post-surgery.

Results: In the PreserFlo group 12% of cases were classified as failure (Requiring reoperation with trabeculectomy, PreserFlo, revision or Ahmed valve). An additional 13% still required glaucoma medications to achieve target IOP. In the PreserFlo group IOP was reduced from 25.2 mmHg to 12.12 mmHg. Medications were reduced from 3.6 to 0.8. Diamox use was reduced from 22 patients requiring it to 4 patients. Surgical revision was required for 8 patients. Persistent hypotony was present for 2 patients. In the patch graft/ripcord group IOP was reduced from 25.6 mmHg to 9.5 mmHg. Number of glaucoma drops was reduced from 3.2 to 0.3 in the patch graft/ripcord group. Diamox was reduced from 9 patients to one patient. Two patients had transient hypotony. No patients had revision surgery or secondary interventions.

Conclusion: Both surgeries significantly reduced intraocular pressure and medication use for patients with moderate to advanced glaucoma. The reoperation and failure rate was higher in the PreserFlo alone group. Both groups had hypotony, but it was transient in the ripcord/patchgraft group. IOP and medication reduction was slightly lower in the patch graft group. Limitations include the reduced sample size in the patch graft/ripcord group. Further long term data is needed to validate the use of patch graft and ripcord with the PreserFlo microshunt. 

 

 

 

Presenter(s)

Presenting Author: Lisa Renaud

Additional Author(s):

Gavin Docherty, Kelowna General Hospital

Mahadev Bhalla, University of British Columbia

Alison Banwell, Queens Univserity

Tushar Dave, University of British Columbia

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