PDF(Pubmed)
Abstract：
Recently, the quest for novel glaucoma surgical techniques and devices has been underway. Trabeculectomy remains the gold standard, but it requires the implantation of glaucoma drainage devices and frequent follow-ups, and it also carries a high risk of serious complications. The need for less invasive and safer procedures has led to the development of minimally invasive glaucoma surgery (MIGS), particularly for patients with mild-to-moderate disease. Among them, minimally invasive bleb surgery seems to be effective in classical glaucoma surgery, while maintaining MIGS benefits. The relatively new PreserFlo® MicroShunt (Santen, Osaka, Japan) is registered in Europe. It was released in 2019 for the treatment of patients with early-to-advanced open-angle glaucoma, where intraocular pressure (IOP) remains uncontrolled while on maximum tolerated medication and/or where glaucoma progression warrants surgery. This review focuses on the place of the PreserFlo MicroShunt, characterized by ab externo implantation, among MIGS procedures, discussing its advantages and disadvantages. The mechanisms of action, technical aspects, efficacy, and safety issues are summarized. The surgical technique, its efficacy, and safety profile are described, and directions for future studies are indicated. The PreserFlo MicroShunt ensures a high safety profile, minimal anatomical disruption, meaningful IOP-lowering effect, and ease of use for patients and physicians.
摘要：
最近,寻求新的青光眼手术技术和设备一直在进行。小梁切除术仍然是黄金标准,但是它需要植入青光眼引流装置和频繁的随访，它也有严重并发症的高风险。对微创和更安全手术的需求导致了微创青光眼手术（MIGS）的发展，特别是对于患有轻度至中度疾病的患者。其中,微创气泡手术在经典青光眼手术中似乎是有效的，同时保持MIGS福利。相对较新的PreservFlo®MicroShunt(Santen，大阪,日本）在欧洲注册。它于2019年发布，用于治疗早期至晚期开角型青光眼患者，在使用最大耐受药物时，眼内压（IOP）仍然不受控制和/或青光眼进展需要手术。这篇评论的重点是PreservFloMicroShunt的位置，以abexterno植入为特征，在MIGS程序中，讨论它的优点和缺点。行动机制，技术方面,功效,并对安全问题进行了总结。手术技术,其功效,并描述了安全状况，并指出了未来研究的方向。PrevereFloMicroShunt确保了高安全性，最小的解剖破坏，有意义的降低IOP的作用，和易于使用的病人和医生。
