000K  utf8
1100  2023$c2023-11-02
1500  eng
2050  urn:nbn:de:gbv:27-dbt-60358-3
2051  10.3390/diagnostics13213373
3000  Hasan, Somar M.
3010  Meller, Daniel
3010  Theilig, Theresa
4000  Comparison of Bleb Morphology following PRESERFLO ® MicroShunt and Trabeculectomy Using Anterior Segment OCT  [Hasan, Somar M.]
4060  12 Seiten
4209  Trabeculectomy has traditionally been upheld as the gold standard in glaucoma surgery, but recent advancements, including the PRESERFLO ® MicroShunt, have introduced less invasive techniques to mitigate complications and reduce intraocular pressure (IOP). The examination of bleb morphology post-filtering surgery is critical for modulating wound healing and ensuring long-term success. While previous evaluations of PRESERFLO-generated blebs have relied on data from trabeculectomy blebs, the differing surgical techniques used in PRESERFLO and trabeculectomy surgeries suggest potential variations in bleb morphologies. This study conducted a comparative analysis of blebs resulting from PRESERFLO and trabeculectomy procedures. Retrospective descriptive assessments using the Jenaer Bleb Grading System were performed, along with quantitative evaluation using eight-dimensional parameters utilizing anterior segment OCT. We included 93 eyes (57 following PRESERFLO, 36 following trabeculectomy). In the descriptive assessment, PRESERFLO-generated blebs exhibited fewer conjunctival cysts (3.5% vs. 22.2%, p = 0.007) and cavernous changes (10.5% vs. 30.5%, p = 0.021) compared to trabeculectomy. Quantitatively, overall bleb dimensions were comparable (maximal bleb height, width, and length, p > 0.05 for all). However, PRESERFLO blebs displayed a shallower (0.52 ± 0.24 vs. 0.67 ± 0.3 mm, p = 0.017) yet longer (4.12 ± 1.54 vs. 3.23 ± 1.64 mm, p = 0.024) episcleral lake. A thicker bleb wall (1.52 ± 0.46 vs. 1.10 ± 0.37 mm, p < 0.001) along with more posteriorly positioned blebs (distance to limbus = 6.16 ± 1.36 vs. 4.87 ± 1.34 mm, p < 0.001) were observed following PRESERFLO. This study illuminates the nuanced morphological differences between PRESERFLO and trabeculectomy blebs. Understanding these distinctions is vital, empowering clinicians to make informed postoperative decisions and avoid misinterpretation of bleb morphology.
4950  https://doi.org/10.3390/diagnostics13213373$xR$3Volltext$534
4950  https://nbn-resolving.org/urn:nbn:de:gbv:27-dbt-60358-3$xR$3Volltext$534
4961  https://www.db-thueringen.de/receive/dbt_mods_00060358
5051  610
5550  anterior segment OCT
5550  bleb morphology
5550  filtering surgery
5550  glaucoma
5550  MIBS
5550  MIGS
5550  PRESERFLO MicroShunt