One-Year Outcomes Of Preserflo Microshunt Implantation In High-Risk Glaucoma Patients

To determine the postoperative outcomes of Preserflo Microshunt implantation in patients with glaucoma including those with a high risk of intra and post-operative complications with trabeculectomy. Parameters of interest included intraocular pressure reduction, progression, and complication rates.

The study was based at a regional NHS ophthalmic centre in the United Kingdom.

This was a retrospective study of Preserflo Microshunt implantation between May 2022 and March 2023. A review of electronic medical records was carried out to obtain demographics, intraocular pressure, visual field and optical coherence tomography data, and number of glaucoma medications. Intraoperative and postoperative complications were also recorded.

Baseline and 3, 6 and 12 month postoperative data was compared. The data was analysed using the paired t-test to determine whether there were changes in intraocular pressure and medications postoperatively, and whether there was glaucoma progression in the cohort.

Thirteen eyes of twelve patients who had completed twelve months of postoperative follow-up were identified. The mean age was 78.15 ±5.57 years and 76.92% had primary open-angle glaucoma (POAG). Baseline IOP and mean deviation were 19.38 ±4.23 mmHg and -12.08 dB, respectively, and patients were on a mean of 2.77 glaucoma agents. Twelve months postoperatively, the mean IOP was 10.62±2.40 mmHg, a mean reduction of 8.77 mmHg or 45.25% (p<0.001). Eleven eyes (84.62%) required no glaucoma medications (p<0.001). There was no significant change in MD (p = 0.058) or RNFL thickness (p = 0.468). Complications included hyphaema (2), choroidal effusions (1), hypotony (1), and choroidal folds (2).

Preserflo Microshunt implantation resulted in a 45.25% decrease in intraocular pressure which was sustained 12 months after surgery. The IOP lowering is notably greater than that achieved by most other available MIGS devices. Complications such as postoperative hyphaema and hypotony were uncommon and transient. Most patients required no glaucoma medications and had no glaucoma progression. This suggests that the Preserflo Microshunt is very efficacious with a favourable side effect profile in patients needing drainage surgery but who are at significant risk of peri- and postoperative complications due to their specific ocular factors.