A Comparative Analysis of Morphology and Dimensions of Functional Blebs following PRESERFLO-Microshunt and XEN-Gel-Stent, a Study Using Anterior Segment OCT
Evaluation of bleb morphology is a vital part of successful filtration glaucoma surgery. The PRESERFLO-MicroShunt (PRESERFLO) and XEN-Gel-Stent (XEN) are drainage devices implanted using different surgical approaches (ab externo and ab interno, respectively), potentially resulting in distinct bleb m...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-07-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/13/14/2318 |
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| author | Somar M. Hasan Theresa Theilig Menelaos Papadimitriou Daniel Meller |
| author_facet | Somar M. Hasan Theresa Theilig Menelaos Papadimitriou Daniel Meller |
| author_sort | Somar M. Hasan |
| collection | DOAJ |
| description | Evaluation of bleb morphology is a vital part of successful filtration glaucoma surgery. The PRESERFLO-MicroShunt (PRESERFLO) and XEN-Gel-Stent (XEN) are drainage devices implanted using different surgical approaches (ab externo and ab interno, respectively), potentially resulting in distinct bleb morphology. Understanding these morphological differences is essential for postoperative care. In this study, we retrospectively examined functioning blebs following PRESERFLO and XEN implantation using high-resolution anterior segment OCT imaging. Qualitative assessment utilizing the Jenaer Bleb Grading System and quantitative assessment measuring 12 parameters representing bleb dimensions were conducted, and the results were compared between the two groups. A total of 80 eyes from 80 patients were included (41 after PRESERFLO, 39 after XEN). Functioning blebs following PRESERFLO exhibited a higher frequency of hyperreflective tenon changes compared to XEN (31.7% vs. 10.3%, respectively, <i>p</i> = 0.02) and a lower frequency of cavernous changes (17.1% vs. 35.9%, <i>p</i> = 0.05). Additionally, PRESERFLO blebs showed a higher frequency of visible episcleral lakes (92.7% vs. 30.8%, <i>p</i> < 0.001). Furthermore, PRESERFLO blebs demonstrated larger height (2.13 ± 0.5 vs. 1.85 ± 0.6 mm, <i>p</i> = 0.03), width (10.31 ± 2.3 vs. 9.1 ± 2.3 mm, <i>p</i> = 0.02), length (9.13 ± 1.8 vs. 8.24 ± 1.9 mm, <i>p</i> = 0.04), posterior location relative to the limbus (6.21 ± 1.2 vs. 5.21 ± 1.8 mm, <i>p</i> = 0.005), and a thicker bleb wall (1.60 ± 0.5 vs. 1.1 ± 0.4 mm, <i>p</i> = 0.004). Functioning blebs following PRESERFLO and XEN displayed morphological distinctions, likely attributed to variations in surgical techniques (ab externo vs. ab interno) and stent dimensions. These morphological differences should be taken into consideration when evaluating blebs, as they could impact assessments of bleb functionality and influence decisions regarding postoperative interventions. |
| first_indexed | 2024-03-11T01:09:49Z |
| format | Article |
| id | doaj.art-84484227bc484ae09e8ef99534a85154 |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-11T01:09:49Z |
| publishDate | 2023-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-84484227bc484ae09e8ef99534a851542023-11-18T18:57:00ZengMDPI AGDiagnostics2075-44182023-07-011314231810.3390/diagnostics13142318A Comparative Analysis of Morphology and Dimensions of Functional Blebs following PRESERFLO-Microshunt and XEN-Gel-Stent, a Study Using Anterior Segment OCTSomar M. Hasan0Theresa Theilig1Menelaos Papadimitriou2Daniel Meller3Department of Ophthalmology, Jena University Hospital, 07747 Jena, GermanyDepartment of Ophthalmology, Jena University Hospital, 07747 Jena, GermanyDepartment of Ophthalmology, Jena University Hospital, 07747 Jena, GermanyDepartment of Ophthalmology, Jena University Hospital, 07747 Jena, GermanyEvaluation of bleb morphology is a vital part of successful filtration glaucoma surgery. The PRESERFLO-MicroShunt (PRESERFLO) and XEN-Gel-Stent (XEN) are drainage devices implanted using different surgical approaches (ab externo and ab interno, respectively), potentially resulting in distinct bleb morphology. Understanding these morphological differences is essential for postoperative care. In this study, we retrospectively examined functioning blebs following PRESERFLO and XEN implantation using high-resolution anterior segment OCT imaging. Qualitative assessment utilizing the Jenaer Bleb Grading System and quantitative assessment measuring 12 parameters representing bleb dimensions were conducted, and the results were compared between the two groups. A total of 80 eyes from 80 patients were included (41 after PRESERFLO, 39 after XEN). Functioning blebs following PRESERFLO exhibited a higher frequency of hyperreflective tenon changes compared to XEN (31.7% vs. 10.3%, respectively, <i>p</i> = 0.02) and a lower frequency of cavernous changes (17.1% vs. 35.9%, <i>p</i> = 0.05). Additionally, PRESERFLO blebs showed a higher frequency of visible episcleral lakes (92.7% vs. 30.8%, <i>p</i> < 0.001). Furthermore, PRESERFLO blebs demonstrated larger height (2.13 ± 0.5 vs. 1.85 ± 0.6 mm, <i>p</i> = 0.03), width (10.31 ± 2.3 vs. 9.1 ± 2.3 mm, <i>p</i> = 0.02), length (9.13 ± 1.8 vs. 8.24 ± 1.9 mm, <i>p</i> = 0.04), posterior location relative to the limbus (6.21 ± 1.2 vs. 5.21 ± 1.8 mm, <i>p</i> = 0.005), and a thicker bleb wall (1.60 ± 0.5 vs. 1.1 ± 0.4 mm, <i>p</i> = 0.004). Functioning blebs following PRESERFLO and XEN displayed morphological distinctions, likely attributed to variations in surgical techniques (ab externo vs. ab interno) and stent dimensions. These morphological differences should be taken into consideration when evaluating blebs, as they could impact assessments of bleb functionality and influence decisions regarding postoperative interventions.https://www.mdpi.com/2075-4418/13/14/2318glaucoma filtering surgeryminimally invasive glaucoma surgerybleb surgeryoptical coherence tomographybleb morphologyPRESERFLO Microshunt |
| spellingShingle | Somar M. Hasan Theresa Theilig Menelaos Papadimitriou Daniel Meller A Comparative Analysis of Morphology and Dimensions of Functional Blebs following PRESERFLO-Microshunt and XEN-Gel-Stent, a Study Using Anterior Segment OCT Diagnostics glaucoma filtering surgery minimally invasive glaucoma surgery bleb surgery optical coherence tomography bleb morphology PRESERFLO Microshunt |
| title | A Comparative Analysis of Morphology and Dimensions of Functional Blebs following PRESERFLO-Microshunt and XEN-Gel-Stent, a Study Using Anterior Segment OCT |
| title_full | A Comparative Analysis of Morphology and Dimensions of Functional Blebs following PRESERFLO-Microshunt and XEN-Gel-Stent, a Study Using Anterior Segment OCT |
| title_fullStr | A Comparative Analysis of Morphology and Dimensions of Functional Blebs following PRESERFLO-Microshunt and XEN-Gel-Stent, a Study Using Anterior Segment OCT |
| title_full_unstemmed | A Comparative Analysis of Morphology and Dimensions of Functional Blebs following PRESERFLO-Microshunt and XEN-Gel-Stent, a Study Using Anterior Segment OCT |
| title_short | A Comparative Analysis of Morphology and Dimensions of Functional Blebs following PRESERFLO-Microshunt and XEN-Gel-Stent, a Study Using Anterior Segment OCT |
| title_sort | comparative analysis of morphology and dimensions of functional blebs following preserflo microshunt and xen gel stent a study using anterior segment oct |
| topic | glaucoma filtering surgery minimally invasive glaucoma surgery bleb surgery optical coherence tomography bleb morphology PRESERFLO Microshunt |
| url | https://www.mdpi.com/2075-4418/13/14/2318 |
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