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Bleb geometry and morphology after Preserflo Microshunt surgery: Risk factors for surgical failure

PURPOSE: To investigate the possible risk factors for treatment failure in patients who had undergone Preserflo Microshunt (PMS) implantation, using anterior-segment optical coherence tomography (AS-OCT) to analyze the internal structures of the bleb. METHODS: The PMS blebs of 54 patients were evalu...

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Autores principales: Ibarz Barberá, Marta, Hernández-Verdejo, Jose Luis, Bragard, Jean, Morales-Fernández, Laura, Rodríguez-Carrillo, Lola, Martínez Galdón, Fátima, Tañá, Pedro, Teus, Miguel A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10249890/
https://www.ncbi.nlm.nih.gov/pubmed/37289791
http://dx.doi.org/10.1371/journal.pone.0286884
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author Ibarz Barberá, Marta
Hernández-Verdejo, Jose Luis
Bragard, Jean
Morales-Fernández, Laura
Rodríguez-Carrillo, Lola
Martínez Galdón, Fátima
Tañá, Pedro
Teus, Miguel A.
author_facet Ibarz Barberá, Marta
Hernández-Verdejo, Jose Luis
Bragard, Jean
Morales-Fernández, Laura
Rodríguez-Carrillo, Lola
Martínez Galdón, Fátima
Tañá, Pedro
Teus, Miguel A.
author_sort Ibarz Barberá, Marta
collection PubMed
description PURPOSE: To investigate the possible risk factors for treatment failure in patients who had undergone Preserflo Microshunt (PMS) implantation, using anterior-segment optical coherence tomography (AS-OCT) to analyze the internal structures of the bleb. METHODS: The PMS blebs of 54 patients were evaluated with AS-OCT. A mathematical model was used to calculate the total filtering surface of the episcleral fluid cavity (EFC) and the hydraulic conductivity (HC) of the bleb wall. Complete and qualified success were defined as IOP between 6 and 17 mmHg with or without glaucoma medication. The relation between baseline characteristics and probability of bleb success was analyzed by bivariate and multivariate logistic regression. The main outcome measures were mean bleb wall thickness (BWT), reflectivity (BWR), HC, mean horizontal and vertical diameter and total filtering surface (TFS) of the EFC. RESULTS: Blebs from 74% patients were considered as complete success and 26% as failure. BWR and BWT increased linearly up to the first year in both groups. BWR was higher in the group failure (p = 0.02) and BWT in the group success (p<0.001). EFC was wider and shorter in the success group (p = 0.009, p = 0.03). Higher TFS showed a negative correlation with IOP (r = -0.4, p = 0.002). Higher baseline IOP was associated with success of PMS by multivariate analysis (p = 0.01). Mean HC, 0.034 ± 0.008 (μL/min)/mm(2)/mmHg, was negatively correlated with bleb surface (r = -0.5, p<0.0001) and wall´s thickness (r = -0.3, p = 0.01). CONCLUSIONS: AS-OCT revealed that successful PMS blebs could show either thick hyporreflective walls or wide filtering surfaces with thin capsules. A higher baseline IOP increased the probability of surgical success.
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spelling pubmed-102498902023-06-09 Bleb geometry and morphology after Preserflo Microshunt surgery: Risk factors for surgical failure Ibarz Barberá, Marta Hernández-Verdejo, Jose Luis Bragard, Jean Morales-Fernández, Laura Rodríguez-Carrillo, Lola Martínez Galdón, Fátima Tañá, Pedro Teus, Miguel A. PLoS One Research Article PURPOSE: To investigate the possible risk factors for treatment failure in patients who had undergone Preserflo Microshunt (PMS) implantation, using anterior-segment optical coherence tomography (AS-OCT) to analyze the internal structures of the bleb. METHODS: The PMS blebs of 54 patients were evaluated with AS-OCT. A mathematical model was used to calculate the total filtering surface of the episcleral fluid cavity (EFC) and the hydraulic conductivity (HC) of the bleb wall. Complete and qualified success were defined as IOP between 6 and 17 mmHg with or without glaucoma medication. The relation between baseline characteristics and probability of bleb success was analyzed by bivariate and multivariate logistic regression. The main outcome measures were mean bleb wall thickness (BWT), reflectivity (BWR), HC, mean horizontal and vertical diameter and total filtering surface (TFS) of the EFC. RESULTS: Blebs from 74% patients were considered as complete success and 26% as failure. BWR and BWT increased linearly up to the first year in both groups. BWR was higher in the group failure (p = 0.02) and BWT in the group success (p<0.001). EFC was wider and shorter in the success group (p = 0.009, p = 0.03). Higher TFS showed a negative correlation with IOP (r = -0.4, p = 0.002). Higher baseline IOP was associated with success of PMS by multivariate analysis (p = 0.01). Mean HC, 0.034 ± 0.008 (μL/min)/mm(2)/mmHg, was negatively correlated with bleb surface (r = -0.5, p<0.0001) and wall´s thickness (r = -0.3, p = 0.01). CONCLUSIONS: AS-OCT revealed that successful PMS blebs could show either thick hyporreflective walls or wide filtering surfaces with thin capsules. A higher baseline IOP increased the probability of surgical success. Public Library of Science 2023-06-08 /pmc/articles/PMC10249890/ /pubmed/37289791 http://dx.doi.org/10.1371/journal.pone.0286884 Text en © 2023 Ibarz Barberá et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Ibarz Barberá, Marta
Hernández-Verdejo, Jose Luis
Bragard, Jean
Morales-Fernández, Laura
Rodríguez-Carrillo, Lola
Martínez Galdón, Fátima
Tañá, Pedro
Teus, Miguel A.
Bleb geometry and morphology after Preserflo Microshunt surgery: Risk factors for surgical failure
title Bleb geometry and morphology after Preserflo Microshunt surgery: Risk factors for surgical failure
title_full Bleb geometry and morphology after Preserflo Microshunt surgery: Risk factors for surgical failure
title_fullStr Bleb geometry and morphology after Preserflo Microshunt surgery: Risk factors for surgical failure
title_full_unstemmed Bleb geometry and morphology after Preserflo Microshunt surgery: Risk factors for surgical failure
title_short Bleb geometry and morphology after Preserflo Microshunt surgery: Risk factors for surgical failure
title_sort bleb geometry and morphology after preserflo microshunt surgery: risk factors for surgical failure
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10249890/
https://www.ncbi.nlm.nih.gov/pubmed/37289791
http://dx.doi.org/10.1371/journal.pone.0286884
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