Intraoperative Oct-Guided Repositioning Of The Preserflotm Implant: A Case Series

Purpose: To assess the role of intraoperative optical coherence tomography (iOCT) in optimizing the positioning of the Preserflo™ microshunt during glaucoma surgery, thereby minimizing endothelial cell loss and improving surgical outcomes.

This case report summarizes three cases that required a repositioning of the PreserfloTM implant after confirming malpositioning with a risking short tube-endothelium distance. Intraoperative OCT (iOCT) was used in these three cases to guide and verify the correct final position of the implant.

Patients and Methods: Three cases of Preserflo™ microshunt repositioning due to inadequate tube-endothelium distance were analyzed. iOCT was utilized intraoperatively to guide and verify correct implant positioning and in office anterior segment optical coherence tomography (AS-OCT) was used to confirm the final tube-endothlium distance.

Results: In all cases, tube endothelium contact was observed in office using AS-OCT and new surgery to replace the Preserflo implant was required. Intraoperative OCT-guided repositioning of the PreserfloTM implant was performed in all cases ensuring a correct tube-endotheliumdistance to preserve endothelial cell density. Endothelial cell density (ECD) remained stable post-surgery and good control of intraocular pressure was obtained.

Conclusions: intraoperative OCT is a useful tool, offering in vivo images of the intraoperative position of the implant Preserflo. iOCT facilitates precise positioning of the Preserflo™ microshunt, ensuring optimal tube-endothelium distance and reducing postoperative endothelial cell loss. This technique enhances surgical outcomes and minimizes postoperative complications in glaucoma patients.