{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T16:37:46Z","timestamp":1766507866524,"version":"3.48.0"},"reference-count":14,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2025,12,21]],"date-time":"2025-12-21T00:00:00Z","timestamp":1766275200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Objectives: The aim of this study was to evaluate the clinical outcomes and surgical techniques of A-stream Glaucoma Shunt (A-stream; MICROT Inc.) implantation. Methods: A retrospective review of 59 eyes from 59 patients who underwent A-stream implantation was conducted. Eyes were divided into two groups: group A (25 eyes), where the distal tip of the ripcord was left exposed and the device was covered with conjunctiva, scleral flap, pericardium patch graft, or mid-posterior Tenon\u2019s capsule advancement flap (MPTAF); and group B (34 eyes), where the ripcord was shaped into a loop at the corneal limbus and the device was covered with MPTAF. Intraocular pressure (IOP), number of IOP-lowering medications, visual acuity, and postoperative complications were analyzed. Success was defined as an IOP \u2264 21 mmHg with \u226520% reduction from baseline, without clinically significant hypotony, and no reoperation for glaucoma. Results: At 6 months, the mean IOP decreased significantly in both groups (group A: 27.4 \u00b1 9.8 mmHg to 15.2 \u00b1 5.1 mmHg; group B: 25.1 \u00b1 11.6 mmHg to 14.0 \u00b1 7.0 mmHg, p &lt; 0.001). Success rates were 76.0% in group A and 88.2% in group B (p = 0.207). Early postoperative hypotony occurred in 8.0% of group A and 14.7% of group B, and these cases resolved without further intervention within 1 month. Ripcord complications were observed in 28.0% of group A, but none in group B. Conclusions: A-stream implantation with MPTAF and a limbal ripcord loop is an effective and safe procedure with minimal risk of device exposure and ripcord-related complications.<\/jats:p>","DOI":"10.3390\/jcm15010056","type":"journal-article","created":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T14:27:47Z","timestamp":1766500067000},"page":"56","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Early Clinical Experience with the Novel A-Stream Glaucoma Shunt Combined with Mid-Posterior Tenon\u2019s Capsule Advancement Flap"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3716-6496","authenticated-orcid":false,"given":"Young Hoon","family":"Hwang","sequence":"first","affiliation":[{"name":"Central Seoul Eye Center, Seoul 04427, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sharon","family":"Lee","sequence":"additional","affiliation":[{"name":"Central Seoul Eye Center, Seoul 04427, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mijin","family":"Kim","sequence":"additional","affiliation":[{"name":"Central Seoul Eye Center, Seoul 04427, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jaewan","family":"Choi","sequence":"additional","affiliation":[{"name":"Central Seoul Eye Center, Seoul 04427, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1584","DOI":"10.1038\/s41433-025-03728-y","article-title":"Short-term efficacy and safety of A-stream glaucoma shunt: A 6-month study","volume":"39","author":"Park","year":"2025","journal-title":"Eye"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"776","DOI":"10.1111\/ceo.12772","article-title":"Novel membrane-tube type glaucoma shunt device for glaucoma surgery","volume":"44","author":"Ahn","year":"2016","journal-title":"Clin. Exp. Ophthalmol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"371","DOI":"10.3341\/kjo.2019.0027","article-title":"Fluid dynamics of small diameter tubes used in membrane-tube type glaucoma shunt devices","volume":"33","author":"Han","year":"2019","journal-title":"Korean J. Ophthalmol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1097\/IJG.0000000000002126","article-title":"Trabeculectomy Tenon advancement technique may reduce bleb-related infections","volume":"32","author":"Mambo","year":"2023","journal-title":"J. Glaucoma"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1097\/IJG.0000000000001465","article-title":"The Tenons\u2019 layer reposition approach of trabeculectomy: A longitudinal case series of a mixed group of glaucoma patients","volume":"29","author":"Chan","year":"2020","journal-title":"J. Glaucoma"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"3203","DOI":"10.4103\/ijo.IJO_3148_21","article-title":"The role of Tenonplasty in the management of limbal and scleral ischemia due to acute ocular chemical burns","volume":"70","author":"Sharma","year":"2022","journal-title":"Indian J. Ophthalmol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"462","DOI":"10.1097\/IOP.0b013e3181dac629","article-title":"Closure of mid-posterior Tenon\u2019s capsule in enucleation","volume":"26","author":"Cho","year":"2010","journal-title":"Ophthalmic Plast. Reconstr. Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"769","DOI":"10.1007\/s00417-022-05831-2","article-title":"Risk factors for ocular hypotony after XEN Gel Stent implantation","volume":"261","author":"Galimi","year":"2023","journal-title":"Graefes Arch. Clin. Exp. 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Ophthalmol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/1\/56\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T14:47:26Z","timestamp":1766501246000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/1\/56"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,21]]},"references-count":14,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1]]}},"alternative-id":["jcm15010056"],"URL":"https:\/\/doi.org\/10.3390\/jcm15010056","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,21]]}}}