Preserflo Microshunt - The Better Trabeculectomy? Our Long-Term Results With The Microshunt In Surgical Glaucoma Therapy

Over the past decade, a number of minimal invasive glaucoma surgeries (MIGS) for patients with open-angel-glaucoma (OAG) have been developed. The PreserFlo Microshunt (Santen) is a glaucoma implant for subconjunctival drainage from an external approach. The shunt consists of Styrene-Isobutylene-Styrene which was originally developed for vascular surgery.
Here we present our newest results on the effectiveness of intraocular pressure (IOP) reduction, safety and rate of complications as well as postoperative treatment and need of second surgery in patients OAG treated with PreserFlo Microshunt.

All patients were treated and observed at Breyer Kaymak Klabe Augenchirurgie Düsseldorf, Germany.

The Preserflo Microshunt was implanted in 130 eyes of 96 patients as a standalone procedure. We monitored the intraocular pressure, the number of postoperative medication as well as visual acuity, visual field defects and endothelial cell loss. Regular monitoring of the filter zone by swept-source-OCT was additionally performed.

96 patients were treated with PreserFlo Microshunt, 40% of these glaucoma patients had undergone a surgical pretreatment. 44% of patients were pseudophakic, and the mean age at surgery was 69±12 years. All eyes showed a significant reduction in IOP during the postoperative observation period. The mean medicated baseline IOP was 28.3±8.9 mmHg. One day postoperative the IOP decreased to 9.6±4.2 mmHg , after 12 months 12.9±2.4 mmHg and after 24 months 13.8±3.6 mmHg. The number of medications decreased from 2.7±1.2 to 0.06±0.3 at month 12 and to 0.4±0.9 after month 24. After a reduction, the visual acuity recovered to the original visual acuity within 2-3 weeks. Needling and revision rate depends strongly to the used concentration of MMC.

After two years, the PreserFlo MicroShunt shows a very effective and lasting reduction of intraocular pressure. The number of complications was significantly lower compared to published data for trabeculectomy . If the IOP lowering effect prolongs over a longer period and the safety data are as good as today the PreserFlo Microshunt could be an alternative to trabeculectomy in cases of open angle glaucoma.