In vivo analysis of conjunctiva in gold micro shunt implantation for glaucoma

International audienceAims: To describe the conjunctival epithelial features seen with in vivo confocal microscopy (IVCM) after gold micro shunt (GMS) implantation in the suprachoroidal space, in patients with uncontrolled glaucoma. Methods: This was an observational case series study. Fourteen eyes of 14 consecutive glaucomatous patients with a history of multiple failed incisional surgeries followed by GMS implantation, were evaluated with digital confocal Laser-Scanning Microscope (HRT II Rostock Cornea Module). Patients were divided into two groups: successful implantations (Group 1: eight patients, eight eyes), defined as a one-third reduction in preoperative intraocular pressure (IOP) with or without antiglaucoma medications and failed implantations (Group 2: six patients, six eyes) as a less than one-third reduction in preoperative IOP with maximal tolerated medical therapy. The examination was performed from three to 20 months (mean 15.4±5.4) postoperatively. Conjunctival mean microcyst density (MMD: cysts/mm2) and mean microcyst area (MMA: µm2) were the main outcome measurements. Results: The mean post-operative IOP was statistically different between the 2 groups (P<0.05), with the values of 14.3±2.77 and 32.3±8.01 mmHg in Group 1 and 2, respectively. When comparing successful with failed implantation, the IVCM analysis showed a greater MMD (P<0.01) and MMA (P