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

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Submitted:

31 July 2022

Posted:

02 August 2022

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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.
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Subject: Medicine and Pharmacology  -   Ophthalmology
Copyright: This open access article is published under a Creative Commons CC BY 4.0 license, which permit the free download, distribution, and reuse, provided that the author and preprint are cited in any reuse.
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