Management Of Hypotony Secondary To Cyclodialysis After Preserflo® Microshunt Implantation: A Case Report
Published 2026 - 44th Congress of the ESCRS
Reference: POCOR004 | Type: Case Report | DOI: 10.82333/2emj-jc41
Authors: Dr Maribel Acuña Salles* 1 , Dr Elena Arrondo Murillo 1 , Dr Eva Ramón Juan 1 , Dr Alberto Salmoral Lorenzo - Arroyo 1 , Dr Natalino Giuliano Salas 1
1Instituto de Microcirugía Ocular IMO Barcelona,Barcelona,Spain
Purpose
To describe the management of hypotony secondary to cyclodialysis following Preserflo® MicroShunt implantation.
Setting
Instituto de Microcirugía Ocular IMO Barcelona
Report of case
A 79-year-old male with bilateral open-angle glaucoma, previously treated with trabeculectomy in both eyes three years earlier, presented with a non-functioning bleb in the left eye (LE). Intraocular pressure (IOP) in the LE was 21 mmHg despite maximal medical therapy. Best-corrected visual acuity (BCVA) was 0.4. A Preserflo® MicroShunt was implanted in the superonasal quadrant of the LE. One week postoperatively, IOP decreased to 5 mmHg, and serous choroidal detachments (SCD) were observed in the LE. Ultrasound biomicroscopy revealed a probable cyclodialysis cleft at the site where the Preserflo entered the anterior chamber. Despite treatment with topical cycloplegics and intensive corticosteroid therapy, by postoperative week four the IOP remained at 4 mmHg and the SCD persisted. Surgical revision was therefore performed, and the implant was repositioned 1 mm away from the cyclodialysis cleft. Two weeks after revision surgery, both hypotony and SCD had resolved.
Conclusion/Take home message
This case highlights the value of complementary diagnostic testing, such as ultrasound biomicroscopy, in identifying complications such as cyclodialysis clefts and SCD, and emphasizes the importance of timely surgical intervention when medical treatment fails.