Surgery SIG corner
July 21, 2024

Surgery SIG corner

SIG Corner Editor: Hana Abou Zeid

Chair: Julian Garcia Feijoo Co-chair: Keith Barton

Preserflo MicroShunt: Minimizing Corneal Endothelial Cell Impact with Proper Positioning

Dr Laura Morales

Preserflo MicroShunt is an effective glaucoma treatment with a favourable safety profile and it has been associated with variable impacts on corneal endothelial cells(1). Recent studies indicate that endothelial cell density (ECD) may experience minimal changes post-implantation. Over a one-year period, ECD decreased by approximately -5.2% after Preserflo microshunt (2). After two years, a higher percentage change of ECD from baseline was observed after trabeculectomy (-9.6%) than after Preserflo microshunt (-7.7%) (2). Maintaining a sufficient distance between the tube and the corneal endothelium is crucial to minimize ECD loss, emphasizing the importance of correct surgical technique and positioning. Distances greater than 600 microns significantly reduce the risk of ECD loss, nearing zero (3).

  1. Gassel CJ, Wenzel DA, Nasyrov E, Strasser T, Voykov B. 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. Graefes Arch Clin Exp Ophthalmol. 2024 May 21.

  2. García-Feijoó, J. MicroShunt vs Trabeculectomy: Interim Safety Observations From an Ongoing Open Label Extension Study in Patients With Primary Open-Angle Glaucoma. World Glaucoma Congress, 2023. Santen. Web. https://www.santen.eu.

  3. Ibarz-Barberá, M., Morales-Fernández, L., Corroto-Cuadrado, A. et al. Corneal Endothelial Cell Loss After PRESERFLO™ MicroShunt Implantation in the Anterior Chamber: Anterior Segment OCT Tube Location as a Risk Factor. Ophthalmol Ther 11, 293–310 (2022).


SURGERY SIG MEETINGS ACTIVITIES AND FUTURE ACTIONS
In the last two years we have been working to update the group and its objectives within the framework of the EGS.

  1. During the last EGS Congress in Dublin, a Surg. SIG members meeting was held. The format was a discussion forum on hot topics in glaucoma surgery.

  2. SIG members participated and are currently working on different EGS initiatives related with glaucoma surgery.

Future actions
  1. Mentoring program. As part of the EGS education program the Surg SIG is developing a mentoring program on glaucoma surgery to start next year.

  2. On line Discussion Forum. The creation of this Forum is the second objective or the next year. It will allow the Surg SIG members to discuss over complex cases, provide tips and advice.


“The views expressed of EGS SIGs are those of the author(s) and not necessarily those of the EGS”

The search for EGS goal of “Paving the Way to Better Glaucoma Care” continues together with Outcome and other EGS Committees as well as SIGs, i.e. how to promote the best possible well-being and minimal glaucoma-induced visual disability in individuals with glaucoma within affordable healthcare systems. The views expressed are those of the author(s) and are not necessarily those of the EGS.

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