BACKGROUND The prevalence of autonomic nervous system disorders is increasing due to the complications of chronic illnesses that become more severe with age. The Composite Autonomic Symptom Score-31 (COMPASS-31) is a questionnaire that assesses autonomic function and has been utilized globally. This study aimed to conduct cultural adaptation and validation of the COMPASS-31 in Indonesia, particularly for the elderly. METHODS This cross-sectional study involved elderly individuals aged 60 years and older. The process included translation, cultural adaptation, back-translation, and reliability tests. The COMPASS-31 questionnaire was translated from English to Indonesian by a certified translator, a native Indonesian speaker without medical background. A panel of experts comprising a neurologist, a gerontologist, and a physiologist discussed the translated questionnaire and made cultural adaptations. Facial and content validity tests were conducted on 11 elderly individuals. The inputs for revision are discussed by the expert panel. The questionnaire was then back-translated into English by a native English speaker, professional translator, without a medical background. The questionnaire was checked for reliability in 52 elderly subjects. Reliability testing was conducted separately for the binomial and polynomial questions of the COMPASS-31 questionnaire. RESULTS The reliability test yielded a Cronbach’s alpha of 0.729 for the binomial questions and 0.722 for the polynomial questions, indicating high reliability. CONCLUSIONS The Indonesian version of COMPASS-31 questionnaire is a valid and reliable symptom assessment tool for use in the elderly.
BACKGROUND Delirium is common in geriatric inpatients and may increase hospital burden. This study aimed to analyze the association of length of stay (LOS), in-hospital mortality, and 30-day readmission among geriatric inpatients at a secondary hospital in Jakarta. METHODS A retrospective study was conducted using secondary data from geriatric inpatients assessed with the comprehensive geriatric assessment (CGA) at Atma Jaya Hospital (March 2024–February 2025). Demographic, functional, nutritional, frailty, and comorbidity variables and clinical outcomes (LOS, mortality, and readmission) were analyzed using t-tests, Fisher’s exact tests, and adjusted odds ratios (aORs) with 95% confidence intervals (CIs). RESULTS Of 425 patients, delirium was identified in 7.8% of patients. Compared with non-delirium groups, the delirium groups had poorer clinical characteristics, including lower activities of daily living, malnutrition, higher frailty, and greater comorbidity burden. Delirium groups had longer LOS (13.88 [9.24] versus 6.36 [5.25] days; p<0.001) and higher 30-day readmission (15.2% versus 3.6%; aOR: 4.821, 95% CI: 1.62–14.353; p = 0.011), while in-hospital mortality was higher but not statistically significant (p = 0.322). CONCLUSIONS Delirium in geriatric inpatients is associated with prolonged LOS and increased risk of readmission. These findings underscore the importance of early detection and CGA-guided interdisciplinary management to reduce hospital burden and improve clinical outcomes for older adults.
The increasing prevalence of vascular cognitive impairment (VCI) underscores the critical need for innovative non-pharmacological strategies. This retrospective comparative case series evaluated the effects of classical music therapy, Qur’anic recitation, and their combination on cognitive function and religious engagement in 7 patients with VCI due to rare disorders, including vasculitis related to systemic lupus erythematosus and Balint syndrome. Assessments included brain magnetic resonance imaging, the Indonesian version of the Montreal Cognitive Assessment, the dementia solat score, and C-reactive protein levels. Patients who received only Qur’anic recitation demonstrated the most significant improvement in cognitive function and religious engagement. The findings suggest that Qur’anic recitation therapy has yielded superior results despite potential sound wave conflicts. Future studies with larger samples are required to validate these findings and explore further non-pharmacological interventions for VCI.
BACKGROUND Systemic lupus erythematosus (SLE) is a chronic autoimmune disorder that impacts several organ systems. Regulatory T cells (Tregs) are essential for maintaining immunological tolerance, and their dysregulation has been found linked to the pathogenesis of SLE. This study aimed to evaluate the correlation between CD4⁺CD25⁺FOXP3⁺ Treg levels and disease activity, as measured by the MEX-SLEDAI score, in patients with SLE. METHODS A cross-sectional study was conducted involving 40 SLE patients treated in the Allergy and Immunology outpatient clinic and inpatient ward of Mohammad Hoesin Hospital from June 1, 2024 to August 31, 2024. Inclusion criteria were adults (≥18 years) diagnosed with SLE who provided informed consent. Exclusion criteria included other history autoimmune or immunocompromised conditions, pregnancy or lactation, hormonal contraceptive use, and active severe infection. CD4⁺CD25⁺FOXP3⁺ Treg cell levels were measured by flow cytometry. Disease activity was assessed using the MEX-SLEDAI score. Spearman’s correlation test was used to analyze the association between Treg levels and disease activity. RESULTS Of 40 enrolled subjects (39 women, 1 man), 75% were aged 20–44 years. Mucocutaneous manifestations were the most common clinical feature (95%). Nephritis and hematologic involvement were most frequently observed in patients with severe disease activity. A strong negative correlation was identified between CD4⁺CD25⁺FOXP3⁺ Treg cell levels and MEX-SLEDAI scores (R = –0.72, p<0.001), indicating that lower Treg levels were associated with higher disease activity. CONCLUSIONS CD4⁺CD25⁺FOXP3⁺ Treg levels show a significant negative correlation with MEX-SLEDAI disease activity in SLE. Lower Treg cell levels reflect more severe disease activity.
Bulbar urethral ischemic necrosis (BUIN) is an unfortunate complication of urethroplasties. This is a result of previous unsalvageable strictures resulting from previous repairs. Here, we present the first case of entero-urethroplasty performed using a sigmoid flap. A 27-year-old man visited the urology clinic with a complaint of urine retention on cystostomy 1 year prior. He had a motor vehicle accident that injured the urethra. He had previously undergone excision and primary anastomosis (EPA) urethroplasty and redo EPA; however, the results were unsatisfactory. Entero-urethroplasty was performed using a sigmoid colon flap harvested carefully from the patient's sigmoid colon, and reconstructive options are limited to BUIN. The sigmoid flap reconstruction appears for treating BUN. This study's limitation is the short follow-up period. Therefore, further studies and long-term follow-up should be performed to assess the effectiveness of this technique.
BACKGROUND Exergames have been proven to effectively improve physical function, particularly in the elderly. Although, older adults were once considered a low-tech population, tailored exergame interventions have proven beneficial. However, utilizing virtual reality (VR) in group presents challenges related to both cognitive acceptance and cardiovascular tolerance. This study aimed to evaluate cardiovascular responses, safety, and exercise intensity or VR-based exergaming in an acute care setting and to explore what to consider when giving exergames to subjects with high comorbidity. METHODS This pre-post study used the Oculus Meta Quest 2® platform in 32 elderly participants. Each completed a single exergame session. Pre- and post-session assessments included measurements of heart rate (HR), systolic blood pressure (SBP), and diastolic blood pressure (DBP). Cardiopulmonary sentinel signs were monitored thoroughly. RESULTS Post-exergame HR was significantly higher than baseline (82 [18] beats per minute [bpm] versus 79 [17] bpm; p = 0.004; mean difference: 4 [8] bpm). Blood pressure decreased slightly, but not significantly (SBP: −1 [14] mmHg, p = 0.837; DBP: 0 [12] mmHg, p = 0.829). Most participants experienced light-intensity activities (n = 26, 81%). No sentinel events occurred. CONCLUSIONS A single session of VR exergaming safely increased HR above baseline in elderly participants, with activity predominantly classified as light intensity. Further studies should explore the determinants of exergame intensity to optimize prescriptions and tailoring.
BACKGROUND Heart disease in children is frequently diagnosed late in life. This study aimed to establish and validate a scoring system to screen for heart disease in children, based on clinical examinations to accelerate referral. METHODS This 2-phase cross-sectional study was conducted in pediatric cardiology outpatients and emergency room Ngoerah Hospital, Bali, Indonesia, from January to May 2024 and July to October 2024. Children aged 0–18 who were suspected of having heart disease and willing to be research participants were included in this study. Patients who had already been diagnosed with heart disease and acute lower respiratory tract infection were excluded from the study. The chi-square, multivariate logistic regression, and ROC analysis were performed to identify and validate variables eligible for the scoring system. Phase 1 for generating the score, continued to phase 2 to validate the developed score. RESULTS Of 310 patients enrolled, 15 were excluded from the study. Congenital heart disease was the dominant condition in this study. The first model of the scoring system, named VEKARD score, consisted of a significant murmur, exercise intolerance, difficulty in breathing, and SpO2 <95%. The second model replaced SpO2 <95% with cyanosis, which can be used if pulse oximetry is not available. Using a sensitivity-first threshold suitable for screening purposes, a cutoff ≥1 for model 1 and cutoff ≥2 for model 2 yielded sensitivities of 85% and 81.8%, respectively. Both models underwent validation in a sample of 241 patients. The results demonstrated good discriminative performance, with AUC values of 0.859 for model 1 and 0.853 for model 2. CONCLUSIONS The VEKARD score can be used to enhance pediatric heart disease screening and accelerate referral to tertiary healthcare facilities, thereby preventing delays in treatment.
BACKGROUND Diabetic retinopathy (DR) is a leading cause of preventable blindness. However, Indonesia lacks a comprehensive screening program. Artificial intelligence (AI)-assisted screening in primary health care (PHC) is a promising solution. Patient satisfaction is crucial for ensuring the participation and sustainability of such programs. This study aimed to adapt Indonesian version of evaluate client satisfaction questionnaire-18 (CSQ-18) and evaluate its acceptability. METHODS This study was conducted from August 5–29, 2024 at 2 public PHCs in Jakarta. Patients with diabetes underwent DR screening, which included fundus photography and an AI-based grading system (RADR). Referable cases were graded secondarily by ophthalmologists. Satisfaction was assessed from November 10–20, 2024 using the Indonesian-translated CSQ-18, adapted through forward-backward translation, expert review, and pilot testing. Reliability was assessed using Cronbach’s alpha, validity was evaluated using Pearson’s correlation, and satisfaction scores were summarized as descriptive statistics. RESULTS Of 300 selected participants, 216 completed telephone or in-person interviews. The Indonesian CSQ-18 demonstrated a strong internal consistency (Cronbach’s alpha = 0.886). All items showed acceptable item-total correlations. The mean (SD) satisfaction score was 60.19 (5.50) of 72, with a median of 59, indicating high patient satisfaction. Most participants expressed positive perceptions of screening duration, accessibility, and provider competence, although awareness-related items scored slightly lower. Potential interviewer bias and nonresponse may have affected the findings. CONCLUSIONS The Indonesian CSQ-18 is a reliable tool for assessing patient satisfaction with DR screening. These findings confirm the feasibility and acceptability of AI-assisted DR screening at the PHC level, supporting its potential for broader implementation in Indonesia.
BACKGROUND Keloid, a fibroproliferative skin disorder, requires accurate scar assessment. Comprehensive evaluation using a standardized instrument from both patient and observer perspectives is essential to capture its multidimensional impact. This study aimed to translate, culturally adapt, and validate the generic patient and observer scar assessment scale (POSAS) 3.0 into Indonesian for keloid assessment. METHODS A cross-sectional design was adopted following the translation and cultural adaptation guidelines. The instrument was translated into Indonesian by certified translators and administered to 68 keloid patients and 62 dermatologists especially recruited from Pekanbaru and the surrounding areas. Content validity was assessed using the scale-level content validity index average (S-CVI/Ave), construct validity through exploratory factor analysis (EFA), internal consistency with Cronbach’s alpha, test-retest reliability using the intraclass correlation coefficient (ICC), and external validity by correlating the observer scar assessment scale (OSAS) with the modified Vancouver scar scale (mVSS). RESULTS The Indonesian version of the generic POSAS 3.0 demonstrated strong psychometric properties. The S-CVI/Ave was 0.97. The EFA revealed 3 factors for the patient scar assessment scale and two for the OSAS, explaining 71.25% and 73.1% of the variance, respectively. Cronbach’s alpha was 0.79–0.90 and ICC was ≥0.83. External validity was confirmed by a strong correlation with the mVSS (Spearman’s rho = 0.82, p<0.001). CONCLUSIONS The Indonesian adaptation of the POSAS 3.0 is a valid and reliable tool for comprehensive keloid scar assessment. Future research should explore the responsiveness to therapeutic interventions.
BACKGROUND The Indonesian chronic disease management program (PROLANIS) was introduced to provide structured chronic disease management for hypertension and type 2 diabetes (T2D) at the primary healthcare level. This study aimed to evaluate the health-related outcomes of PROLANIS among T2D patients in the eastern border region. METHODS This retrospective cohort study used secondary data from PROLANIS reports of all primary healthcare facilities in Atambua Regency, East Nusa Tenggara Province, Indonesia. Inclusion criteria were all T2D patients who participated in routine 6-month evaluations conducted between June 2023 and December 2023. The assessed parameters and their defined targets were body mass index (BMI) (18.5–23 kg/m²), systolic blood pressure (SBP) (<140 mmHg), diastolic blood pressure (DBP) (<90 mmHg), hemoglobin A1c (HbA1c) (<7%), total cholesterol (TC) (<200 mg/dl), high-density lipoprotein (HDL) (>40 mg/dl for males and >50 mg/dl for females), low-density lipoprotein (LDL) (<100 mg/dl), and triglycerides (TGs) (<150 mg/dl). Wilcoxon signed-rank and paired t-tests were used for statistical analyses. RESULTS There were 51 T2D patients included in the analyses. Of these, 84% achieved SBP and 96% achieved DBP targets. However, only 45% achieved HbA1c, and 33% achieved BMI targets. For lipid profiles, 55%, 51%, 47%, and 41% achieved TC, LDL, HDL, and TG targets, respectively. No significant differences were found between baseline and follow-up across these parameters (all p>0.05). CONCLUSIONS In the border region, while PROLANIS maintains blood pressure levels, it does not significantly improve other health-related outcomes in T2D patients. This underscores the need to strengthen program intensity, support adherence, and address contextual barriers to achieve meaningful metabolic improvements.
Breast cancer (BC) is the most frequently diagnosed malignancy worldwide and a leading cause of death in women. Machine learning (ML) enables data-driven risk stratification and outcome prediction, potentially improving screening, treatment choices, and overall care. This scoping review cataloged ML models used to predict BC risk and post-treatment outcomes. A PubMed search using MeSH terms (“breast neoplasms,” “breast cancer,” “machine learning,” and “predictive value of tests”) retrieved 44 records, with 9 added by manual searching; 24 studies were included. We excluded 29 reports limited to imaging/radiomics or biomolecular/omics, plus other ineligible items. Model usage among included studies: 13 random forest (RF); 13 support vector machine; 7 decision tree; 5 k-nearest neighbors; 4 deep learning; 3 naïve Bayes; 2 artificial neural networks. Average RF accuracy surpassed 90% in most reports, indicating RF is both common and consistently strong for predictive modeling, supporting targeted clinical translation.
Renal angiomyolipoma (AML) is a benign renal tumor that can grow significantly and cause complications, such as hemorrhage and pain, necessitating active intervention. Managing giant AML in young women remains challenging, and evidence for multimodal approaches is limited. This case report describes the management of a giant AML by selective renal angioembolization (RAE) followed by total nephrectomy. A 30-year-old woman presented with an 18 × 20 × 22 cm AML, resulting in bleeding and kidney dysfunction. Total nephrectomy was performed after stabilization with RAE. This multimodal approach reduces surgical risk and preserves renal function. Combining RAE with nephrectomy shows promise for treating complex giant AML and warrants further research to optimize the technique and assess the long-term outcomes.
BACKGROUND The incremental shuttle walk test (ISWT) and six-minute walk test (6MWT) assess cardiorespiratory endurance in sedentary populations, with the ISWT being externally paced and the 6MWT self-paced. This study aimed to evaluate whether both tests produce comparable cardiorespiratory responses. METHODS 100 healthy sedentary adults (18–59 years) from Cipto Mangunkusumo Hospital completed both tests. Outcomes measured included distance traveled, maximal heart rate (HRmax), and Borg scale scores (rating of perceived exertion [RPE], dyspnea, and leg fatigue). RESULTS Of 100 sedentary adults (25 men, 75 women), the ISWT resulted in significantly longer walking distances (p<0.001), higher post-test Borg dyspnea scores (median [interquartile range]: 2 [1–3]) versus 1 [0–2]; p = 0.024), and the higher HRmax (70.9 [9.2%] bpm versus 67.9 [10.9%] bpm; p = 0.004) compared to the 6MWT. No significant differences were observed in other parameters, and Bland–Altman analysis revealed no proportional bias for Borg leg fatigue scores (p = 0.561). CONCLUSIONS In healthy sedentary adults, the 6MWT and ISWT showed no agreement in distance traveled, Borg dyspnea scale scores, or HRmax, but they agreed on Borg leg fatigue scores.
Ophthalmologists rely on wet lab training for both diagnostic procedures and surgical techniques. Existing wet lab devices are limited to surgical training and lack functionality for performing required perioperative diagnostic examinations. This study aimed to develop an affordable, easily manufactured eye holder to enhance ophthalmology training for wet lab simulations. A three-dimensional (3D)-printed animal eye holder was designed in 3D with a funnel-shaped structure resembling an orbital eye socket. The design was optimized for optimal wet lab activities. The animal eye holder device demonstrated potential use for ultrasound biometry, handheld keratometry, tonometry, and ophthalmological surgical training. These activities can be performed effectively after the animals' eyes are stabilized inside the holder in flat and inclined positions. This innovative animal eye holder is the first designed to provide flexible diagnostic practice and surgical training, especially during wet lab activities.
BACKGROUND Poor prognosis in patients with metastatic prostate adenocarcinoma (mPCa) may be due to the expression of stem cell-related genes. This study aimed to demonstrate the association between the expression of cancer stem cell markers and metastasis in patients with castration-naive mPCa. METHODS This cross-sectional, analytical study investigated a formalin-fixed paraffin-embedded prostate specimens from patients diagnosed in Cipto Mangunkusumo Hospital. Patients aged >= 50 years old were grouped based on the extent of metastases (high-volume disease [HVD] and low-volume disease [LVD]). In each case, immunohistochemical staining for CD133, CD44, SOX2, and androgen receptor was performed and analyzed using H-score. All data were recorded and analyzed using SPSS software version 20.0. RESULTS A total of 61 patients were recruited from 2020 to 2023 and divided into the HVD (n = 38) and LVD (n = 23) groups, with a mean age of 67.9 years. 45 of the patients had International Society of Urological Pathology (ISUP) grade 5 disease, while 16 of them had grade <5. A significant difference of ISUP grade and PSA serum level was observed in the HVD versus LVD group (p = 0.017 and <0.001, respectively). Additionally, a significant association was found between SOX2 expression and metastatic extent. CONCLUSIONS The LVD group showed higher SOX2 expression in the primary tumor compared to the HVD group. Different SOX2 expressions in various sites and stages may be due to the cancer cells' systemic network.
BACKGROUND Near-infrared (NIR) fluorescence imaging is one of the most useful diagnostic methods for breast cancer-related lymphedema (BCRL). It utilizes indocyanine green (ICG) lymphography, which requires a commercial camera that is not widely available. This study aimed to qualitatively assess the reliability of the modified NIR camera in diagnosing BCRL. METHODS This prospective cross-sectional study was conducted between December 2023 and December 2024 in breast cancer (BC) patients with BCRL. A commercial mirrorless digital camera was modified by incorporating an excitation light source and spectral filters to enable NIR imaging. To evaluate the camera reliability, intra-and inter-observer agreements were assessed using Kappa analysis. Three independent observers evaluated dermal backflow patterns of lymphatic flow: linear, splash, stardust, and diffuse patterns. RESULTS 60 BC patients with BCRL resulting in 280 images were included. The mean (standard deviation) age was 54.7 (10.1) years and body mass index were 27.1 (4.5) kg/m2. Most patients had stage IIA BC (40%) and stage IV ICG lymphography (38%). Intraobserver analysis showed observers 1 and 2 of had a Kappa of 1.00 (95% confidence interval [CI]: 1.00-1.00), while observer 3 had Kappa of 0.99 (95% CI: 0.97-1.00). Inter-observer analysis between observers 1 and 2 showed Kappa 1.00 (95% CI: 1.00-1.00), while observers 1-3 and 2-3 had Kappa of 0.99 (95% CI: 0.97-1.00). Observer 3 misinterpreted 3 linear as splash patterns. CONCLUSIONS This study showed a high inter-and intra-observer agreements making it reliable for BCRL diagnosis.
BACKGROUND Peripheral nerve injury (PNI) can cause severe functional disabilities and progresses dynamically over time. Since evaluations held at different time points will yield different results, finding an optimal model for PNI comparison is needed. This study aimed to create an animal model of chronic denervation that simulates the progress of nerve injury. METHODS 6 male Sprague-Dawley rats underwent complete sciatic nerve transection in their right hind limbs, with severed nerve ends secured to a nearby muscle to prevent nerve regrowth. The rats were sacrificed at 2, 3, and 4 weeks. The assessment included walking analysis (pre-and post-injury), wet muscle weight measurement, and histological examination. RESULTS Progressive gastrocnemius muscle degeneration was observed at 3 different time points. Minimal degenerative changes were noted at 2 weeks, while extensive fibrosis (83.25 [12.19]% collagen area) appeared in the 4th week. The 3rd-week samples showed lymphocyte infiltrations, muscular atrophy, and progressive fibrosis, making it the best model for chronic PNI. CONCLUSIONS A 3-week chronic denervation model is proposed as a long-term PNI for further regenerative research.
BACKGROUND Pelvic organ prolapse (POP) is a common condition in older women that significantly impacts quality of life (QoL). Traditional surgical success measures primarily focus on anatomical outcomes, but patient-reported outcomes provide offer a more comprehensive assessment of symptom relief and overall well-being. This study aimed to evaluate patient-reported outcomes and QoL with the Pelvic Floor Disability Index (PFDI-20) and Pelvic Floor Impact Questionnaire (PFIQ-7) following POP surgery. METHODS This cross-sectional study analyzed secondary data from medical records and patient interviews at Cipto Mangunkusumo Hospital, Jakarta. Patients diagnosed with POP who underwent surgery were followed up at 1, 3, 6, and 12 months postoperatively. PFDI-20 and PFIQ-7 scores were used to assess symptom impact and QoL. RESULTS Among 34 patients, the most common surgical method was total vaginal hysterectomy (79%), followed by colpocleisis (59%), and sacrospinous hysteropexy (6%). Postoperative PFDI-20 scores showed 76% of patients experienced minimal to no impact, while PFIQ-7 scores indicated 91% reported minimal to no impact on their QoL. 2 patients reported moderate impact, particularly in the urinary domain. No patients experienced severe or very severe impairment at any follow-up interval. CONCLUSIONS Incorporating patient-reported outcomes with anatomical assessments provides a more accurate evaluation of surgical success in POP based on PFDI-20 and PFIQ-7 scores. Because POP is a multidimensional condition, assessing surgical outcomes requires a multimodal approach that considers symptom relief and QoL.
BACKGROUND Glaucoma is the leading cause of irreversible blindness and is primarily managed by reducing intraocular pressure (IOP). Minimally invasive glaucoma surgeries, particularly subconjunctival shunt devices such as Xen (R) Gel Stent and PreserFloTM MicroShunt, have emerged as alternatives to traditional trabeculectomy. This study aimed to evaluate their effectiveness in lowering IOP, reducing medication use, and assessing reinterventions and safety. METHODS A systematic review was conducted in accordance with Cochrane and PRISMAguidelines. Comprehensive literature searcheswere conducted across PubMed, Cochrane, EBSCOhost, and Google Scholar databases from the earliest available date to September 2023. Studies comparing Xen (R) Gel Stent and PreserFloTM MicroShunt in adult patients with glaucoma were included. Data were extracted on study design, sample size, IOP outcomes, antiglaucoma medication use, reinterventions, and safety outcomes. Quality assessment was performed using the Newcastle-Ottawa Scale. RESULTS Of 5 European studies (2020-2023; 329 patients, 6-18 months of follow-up), 3 studies reported lower postoperative IOP with PreserFloTM MicroShunt (11.8 [3.7] versus 13.6 [3.5] mmHg, p = 0.02; 10.3 [2.1] versus 14.2 [2.1] mmHg, p = 0.0005; 10.3 [3.2] versus 13.1 [6.4] mmHg, p = 0.019). Only one study noted fewer antiglaucoma medications with PreserFloTM MicroShunt (0.2 [0.6] versus 1.1 [2.4], p = 0.04). Reinterventions including needling and bleb revisions were higher with Xen (R) Gel Stent (35.4% versus 11.5%; 20% versus 5%). Complication profiles varied, with hypotony more common in Xen (R) Gel Stent (6.5% versus 0%), hyphema more common with PreserFloTM MicroShunt (7.7% versus 3.2%), and stent curling and migration more common with Xen (R) Gel Stent (15% versus 0%; 2% versus 0%), respectively. CONCLUSIONS Both Xen (R) Gel Stent and PreserFloTM MicroShunt effectively lowered IOP and reduced medication burden in patients with glaucoma. PreserFloTM MicroShunt may provide superior IOP control and fewer postoperative interventions. Further prospective studies in diverse populations are warranted.
