Japanese journal of ophthalmology · 2026
Association between distance from the angle recess to the tube entry site and corneal endothelial cell loss after PreserFlo MicroShunt implantation.
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Nishimura Shunsuke, Minami Takahiro, Udagawa Sachiko, Yamashita Yoko, Suzuki Toshiya, Wada Takahiro, Higashide Tomomi
Аннотация
PURPOSE: To investigate the association between anterior segment optical coherence tomography (AS-OCT)-derived tube parameters and corneal endothelial cell density (ECD) changes after PreserFlo MicroShunt (PMS) surgery in primary open-angle glaucoma (POAG) and exfoliation glaucoma (XFG).
STUDY DESIGN: Prospective cohort study.
METHODS: This study included pseudophakic patients with POAG or XFG who underwent PMS implantation. ECD was measured preoperatively and at 1, 3, 6, and 12 months post operatively, and every 6 months thereafter. Intracameral tube parameters, including tube position and length, were assessed using AS-OCT images obtained 1 month postoperatively. Associations between OCT parameters and the monthly rate of ECD change (ECD slope) were evaluated using linear mixed-effects models.
RESULTS: Mean preoperative ECD was 2384 ± 391 cells/mm2. Mean follow-up period was 15 ± 7 months, with 5.1 ± 1.3 ECD measurements per eye. Tube parameters did not differ significantly between POAG (67 eyes of 61 patients) and XFG (18 eyes of 16 patients). The mean ECD slope was -11.8 ± 2.2 cells/mm2/month in XFG and -9.8 ± 1.1 cells/mm2/month in POAG (p = 0.38). A greater distance from the angle recess to the intracameral tube entry site was significantly associated with a more negative ECD slope in both XFG and POAG groups (p = 0.02 and 0.03). Its contribution to ECD slope variance was greater in XFG than in POAG (R2 = 0.243 vs. 0.069).
CONCLUSION: A longer distance from the angle recess to the intracameral tube entry site may predict accelerated ECD loss after PMS implantation, particularly in XFG.
STUDY DESIGN: Prospective cohort study.
METHODS: This study included pseudophakic patients with POAG or XFG who underwent PMS implantation. ECD was measured preoperatively and at 1, 3, 6, and 12 months post operatively, and every 6 months thereafter. Intracameral tube parameters, including tube position and length, were assessed using AS-OCT images obtained 1 month postoperatively. Associations between OCT parameters and the monthly rate of ECD change (ECD slope) were evaluated using linear mixed-effects models.
RESULTS: Mean preoperative ECD was 2384 ± 391 cells/mm2. Mean follow-up period was 15 ± 7 months, with 5.1 ± 1.3 ECD measurements per eye. Tube parameters did not differ significantly between POAG (67 eyes of 61 patients) and XFG (18 eyes of 16 patients). The mean ECD slope was -11.8 ± 2.2 cells/mm2/month in XFG and -9.8 ± 1.1 cells/mm2/month in POAG (p = 0.38). A greater distance from the angle recess to the intracameral tube entry site was significantly associated with a more negative ECD slope in both XFG and POAG groups (p = 0.02 and 0.03). Its contribution to ECD slope variance was greater in XFG than in POAG (R2 = 0.243 vs. 0.069).
CONCLUSION: A longer distance from the angle recess to the intracameral tube entry site may predict accelerated ECD loss after PMS implantation, particularly in XFG.