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Bleb Wall Thickness Not Associated With Secondary Interventions After Preserflo MicroShunt ImplantationEarly bleb scans do not predict future surgery needs in glaucoma

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Key Takeaway
Note early bleb thickness parameters were not associated with future secondary interventions after Preserflo MicroShunt implantation.

This observational cohort study included 23 open-angle glaucoma patients who underwent Preserflo MicroShunt implantation. The study aimed to evaluate structural parameters in the early postoperative phase. Follow-up occurred at 1, 2, and 4 weeks; 2, 3, 6, 9, and 12 months postoperatively.

The primary outcome assessed the correlation of bleb wall thickness and total bleb height with secondary interventions. Neither bleb wall thickness nor total bleb height was significantly associated with future secondary interventions at 1, 2, and 4 weeks. Specific p-values included 1 W: 0.217/0.878, 2 W: 0.670/0.528, 4 W: 0.171/0.430. Additionally, 10 of 23 patients needed secondary interventions between 4 and 48 weeks after Preserflo MicroShunt implantation.

Secondary outcomes examined the correlation of bleb wall thickness and total bleb height with AS-OCTA-derived bleb vessel density. No correlations between bleb wall thickness or total bleb height and bleb vessel density were found. Safety data regarding adverse events, serious adverse events, discontinuations, and tolerability were not reported.

Key limitations include the small sample size of 23 patients. Larger studies are necessary to confirm these hypothesis-generating findings. Structural AS-OCT-based bleb thickness parameters in the early postoperative phase were not significantly associated with future secondary interventions after Preserflo MicroShunt implantation and did not correlate with AS-OCTA-derived bleb vessel density in this cohort.

This small study looked at 23 people with open-angle glaucoma who had Preserflo MicroShunt implantation. The evidence here is limited because the group was very small. Researchers checked if measurements of the fluid drainage area, called blebs, could tell them if patients would need more surgery later.

About half of the patients needed additional procedures between one month and one year after the operation. However, early scans of the bleb wall thickness and height did not predict who would need these extra treatments. There was also no link found between these measurements and blood vessel density in the drainage area.

Safety details were not reported, so we do not know the full risk profile from this data alone. Because the sample size is so small, these results are just a starting point for future research. Larger studies are needed to confirm if these early measurements truly matter for long-term success.

Patients should discuss these findings with their doctors but not expect them to change care plans immediately. This information helps us understand what might happen after surgery, but it does not guarantee outcomes for any single person. More data is required before these measurements can be used to make clinical decisions.

What this means for you:
Early bleb measurements after glaucoma surgery do not predict who needs more treatment, but larger studies are needed.

Study Details

Study typeCohort
EvidenceLevel 3
PublishedApr 2026
View Original Abstract ↓
PurposeThis study aimed to evaluate the anterior segment optical coherence tomography (AS-OCT) parameters bleb wall thickness (BWT) and total bleb height (TBH) in the early postoperative phase after Preserflo MicroShunt (PM) implantation for their correlation with (a) secondary interventions and (b) AS-OCT angiography (AS-OCTA)-derived bleb vessel density (BVD).Materials and methodsIn a prospective longitudinal study of 23 open-angle glaucoma patients, AS-OCT measurements of BWT and TBH and AS-OCTA measurements of BVD were obtained at 1, 2, and 4 weeks (1 W, 2 W, and 4 W), as well as at 2, 3, 6, 9, and 12 months postoperatively. Secondary interventions (needling or open revision) were recorded. The correlations of BWT and TBH with (a) secondary interventions and (b) BVD were assessed.ResultsA total of 10 of 23 patients needed secondary interventions between 4 and 48 weeks after PM implantation. At 1, 2, and 4 weeks after surgery, neither BWT nor TBH was significantly associated with future secondary interventions (BWT/TBH p-values: 1 W: 0.217/0.878, 2 W: 0.670/0.528, and 4 W: 0.171/0.430). Similarly, no correlations between BWT or TBH and BVD were found.ConclusionStructural AS-OCT-based bleb thickness parameters (BWT and TBH) in the early postoperative phase were not significantly associated with future secondary interventions after PM implantation and did not correlate with AS-OCTA-derived BVD. BVD, which was shown to be a viable biomarker for future secondary interventions in a previous analysis of the same cohort, could be a better predictor of secondary interventions after PM implantation than BWT/TBH. Larger studies are necessary to confirm these hypothesis-generating findings.
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