Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Difference in Nycthemeral IOP Variation and Outflow Facility after Filtering Microshunt versus Canal-Based Ab Interno Glaucoma Surgery

Version 1 : Received: 31 July 2022 / Approved: 2 August 2022 / Online: 2 August 2022 (05:09:05 CEST)

How to cite: Dakroub, M.; Barkhuysen, M.; Verma-Fuehring, R.; Bamousa, A.; Hillenkamp, J.; Loewen, N.A. Difference in Nycthemeral IOP Variation and Outflow Facility after Filtering Microshunt versus Canal-Based Ab Interno Glaucoma Surgery . Preprints 2022, 2022080040 (doi: 10.20944/preprints202208.0040.v1). Dakroub, M.; Barkhuysen, M.; Verma-Fuehring, R.; Bamousa, A.; Hillenkamp, J.; Loewen, N.A. Difference in Nycthemeral IOP Variation and Outflow Facility after Filtering Microshunt versus Canal-Based Ab Interno Glaucoma Surgery . Preprints 2022, 2022080040 (doi: 10.20944/preprints202208.0040.v1).

Abstract

Purpose: We hypothesized that a recently introduced epibulbar micro-shunt (PRESERFLO, P) produces nycthemeral (24h) intraocular pressure (IOP) profiles different from ab-interno trabeculectomy (Trabectome, T). P is a flow restrictor that drains fluid into the sub-tenon space. In contrast, T increases conventional outflow, which is limited by episcleral venous pressure. Methods: In this prospective cohort, we analyzed 68 patients (34 P and 34 T) who presented for 24-h IOP monitoring 6 to 12 months after surgery. IOP and tonographic outflow facility were measured in the habitual position using a pneumatonometer. The IOP variation was considered the primary outcome measure. Glaucoma medications were also compared. Results: P had a higher baseline IOP than T (24.8±10.0 vs. 17.3±7.9 mmHg, p=0.001). Postoperatively, P and T had similar nycthemeral IOP profiles, but IOP in P was significantly lower than in T, except at 4 pm. P had a lower absolute IOP variation than T (5.8±2.6 vs. 7.1±2.7 mmHg, p=0.049). The relative IOP variation was similar in both (34.8±13.2 vs. 37.2±13.1, p=0.45) as was the tonographic outflow facility (0.35±0.23 vs. 0.26±0.18 µl/min/mmHg, p=0.097). Conclusion: Nycthemeral IOP profiles of P and T were similar, but P had lower IOPs and less variation than T. This could reflect how T, unlike P, is more impacted by habitual, positional factors, especially at night.

Keywords

glaucoma; PRESERFLO; Trabectome; nycthemeral IOP measurement; tonographic outflow facility

Subject

MEDICINE & PHARMACOLOGY, Ophthalmology

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