Anterior Segment-Optical Coherence Tomography Bleb Morphology Comparison in Minimally Invasive Glaucoma Surgery: XEN Gel Stent vs. PreserFlo MicroShunt

Background: The purpose of this study is to compare the morphology of six-month follow-up blebs created by a subconjunctival glaucoma surgical device (XEN45) to those created by a PreserFlo MicroShunt with a sub-Tenon insertion, utilizing AS-OCT. Methods: A retrospective study of 29 eyes who underwe...

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Bibliographic Details
Published in:Diagnostics (Basel) 2022-05, Vol.12 (5), p.1250
Main Authors: Gambini, Gloria, Carlà, Matteo Mario, Giannuzzi, Federico, Boselli, Francesco, Grieco, Giulia, Caporossi, Tomaso, De Vico, Umberto, Savastano, Alfonso, Baldascino, Antonio, Rizzo, Clara, Kilian, Raphael, Caporossi, Aldo, Rizzo, Stanislao
Format: Article
Language:English
Subjects:
AS-OCT
blebs
Eye surgery
Glaucoma
micro-invasive glaucoma surgery
MicroShunt
mitomycin C
Morphology
Optics
Surgeons
Surgical outcomes
Tomography
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Summary:Background: The purpose of this study is to compare the morphology of six-month follow-up blebs created by a subconjunctival glaucoma surgical device (XEN45) to those created by a PreserFlo MicroShunt with a sub-Tenon insertion, utilizing AS-OCT. Methods: A retrospective study of 29 eyes who underwent XEN45 implantation and 29 eyes who underwent PreserFlo MicroShunt implantation. The patients were analyzed at 24 h, 1 week, 1 month, 3 months and 6 months. At each visit, the maturation and morphological alterations of the blebs were observed, as well as connections with the IOP. Results: In both groups, IOP showed significant reduction at all follow ups (p < 0.0001). In XEN group, the most common bleb morphology in the immediate postoperative was the subconjuntival separation type (42%) followed by the uniform type (34%), with a trend inversion at 6 month follow up (51% of uniform type). On the contrary, the most common morphology after PreserFlo was the multiple internal layer (55%), which showed a tendency to reduce over time and was substituted by the microcystic multiform, whose percentage increased over time (17% at day 1 vs. 44% at month 6). Uniform appearance was associated by the posterior episcleral fluid (PEF) lake presence. Both horizontal and vertical diameters significantly increased over time. Conclusion: XEN and PreserFlo implantation resulted in the production of diffuse blebs with different characteristics, which may influence IOP lowering capacity and bleb revisions necessity over time.
ISSN:2075-4418
2075-4418
DOI:10.3390/diagnostics12051250