LIMBUS-SPARING PRESERFLO MICROSHUNT IMPLANTATION: A NEW ROUTE IN SURGICAL TREATMENT OF GLAUCOMA

PURPOSE: TO EVALUATE WHETHER A LIMBUS-SPARING CONJUNCTIVAL INCISION (2.5 MM FROM THE LIMBUS) AFFECTS INTRAOCULAR PRESSURE (IOP) OUTCOMES AND SAFETY COMPARED WITH STANDARD LIMBAL INCISION DURING PRESERFLO™ MICROSHUNT (PMS) IMPLANTATION, AND TO COMPARE RESULTS WITH TRABECULECTOMY. METHODS: THIS RETROSPECTIVE STUDY INCLUDED 111 GLAUCOMA PATIENTS WHO UNDERWENT PMS IMPLANTATION OR TRABECULECTOMY BETWEEN JUNE 2022 AND JULY 2023. PATIENTS WERE DIVIDED INTO THREE GROUPS: PMS WITH LIMBAL INCISION (N = 37), PMS WITH LIMBUS-SPARING INCISION (N = 37), AND TRABECULECTOMY (N = 37). PREOPERATIVE AND POSTOPERATIVE IOP, BEST-CORRECTED VISUAL ACUITY (BCVA), MEDICATION USE, AND COMPLICATIONS WERE EVALUATED AT 1 MONTH, 6 MONTHS, AND 1 YEAR. RESULTS: BASELINE IOP WAS COMPARABLE AMONG GROUPS. ALL GROUPS SHOWED SIGNIFICANT POSTOPERATIVE IOP REDUCTION. THE LIMBUS-SPARING GROUP DEMONSTRATED SIGNIFICANTLY LOWER IOP AT 6 AND 12 MONTHS COMPARED WITH THE LIMBAL INCISION GROUP, WITH RESULTS COMPARABLE TO TRABECULECTOMY. MEDICATION USE DECREASED MARKEDLY IN ALL GROUPS, WITH NO SIGNIFICANT DIFFERENCES AT FOLLOW-UP. NO RELEVANT INTRAOPERATIVE OR POSTOPERATIVE COMPLICATIONS WERE OBSERVED. CONCLUSIONS: LIMBUS-SPARING PMS IMPLANTATION IS A SAFE AND EFFECTIVE TECHNIQUE AND MAY PROVIDE IMPROVED MID-TERM IOP CONTROL COMPARED WITH STANDARD LIMBAL INCISION, WITH OUTCOMES SIMILAR TO TRABECULECTOMY. FURTHER PROSPECTIVE STUDIES ARE REQUIRED TO CONFIRM THESE FINDINGS AND CLARIFY THE UNDERLYING MECHANISMS.