Impact of Prostaglandin-Associated Periorbitopathy Severity on One-Year Surgical Outcomes After PreserFlo MicroShunt Surgery

Abstract Background/Objectives: To investigate the impact of preoperative prostaglandin-associated periorbitopathy (PAP) severity on 12-month surgical outcomes after standalone PreserFlo MicroShunt surgery in patients with primary open-angle glaucoma. Subjects/Methods: This retrospective, multicentre study included 367 eyes undergoing standalone PreserFlo MicroShunt surgery at three institutions. PAP severity was assessed using the Shimane University Prostaglandin-Associated Periorbitopathy grading system; grades 0–1 were classified as mild and grades 2–3 as severe. Complete and qualified success were assessed from postoperative day 90 using IOP thresholds of ≤ 12 or ≤ 15 mmHg, each with ≥ 20% reduction from baseline, using Kaplan–Meier analysis and Cox proportional hazards models. Results The mild and severe PAP groups included 244 and 123 eyes. PAP severity was not associated with failure for complete success at IOP ≤ 12 mmHg (HR 1.20, 95% CI 0.88–1.64; P = 0.24) or ≤ 15 mmHg (HR 1.06, 95% CI 0.74–1.51; P = 0.75), or qualified success at ≤ 12 mmHg (HR 1.22, 95% CI 0.89–1.66; P = 0.21) or ≤ 15 mmHg (HR 1.12, 95% CI 0.77–1.63; P = 0.55). Intraoperative sub-Tenon triamcinolone acetonide was associated with lower failure risk for the corresponding four definitions (HR 0.67, 95% CI 0.50–0.90; P = 0.007; HR 0.62, 95% CI 0.44–0.87; P = 0.006; HR 0.65, 95% CI 0.48–0.87; P = 0.004; HR 0.64, 95% CI 0.45–0.92; P = 0.02). Conclusions Preoperative PAP severity was not significantly associated with 12-month surgical success after standalone PreserFlo MicroShunt surgery.