Preserflo Microshunt Implantation With And Without Adjunctive Intracameral Bevacizumab: Two-Year Outcomes From A Tertiary Glaucoma Service
Published 2026 - 44th Congress of the ESCRS
Reference: POGAU032 | Type: Free paper | DOI: 10.82333/yqmh-nd15
Authors: Dr Abdus Samad Ansari* 1 , Dr Dalia Abdulhussein 2 , Dr Ibtesham Hossain 2 , Dr Priyancaa Jeyabaladevan 2 , Dr Joseph Olakkengil 2 , Prof. Keith Barton 3 , Dr Poornima Rai 4
1Glaucoma,Moorfields Eye Hospital NHS Foundation Trust,London,United Kingdom;Glaucoma,Singapore National Eye Centre,Singapore,Singapore;School of Life Course Sciences, Faculty of Life Science and Medicine,Kings College London,London,United Kingdom, 2Glaucoma,Moorfields Eye Hospital NHS Foundation Trust,London,United Kingdom, 3Glaucoma,Moorfields Eye Hospital NHS Foundation Trust,London,United Kingdom;Institute of Ophthalmology,UCL,London,United Kingdom, 4Glaucoma,Moorfields Eye Hospital NHS Foundation Trust,Singapore,United Kingdom
Purpose
To compare two-year surgical outcomes following PreserFlo MicroShunt implantation with mitomycin C (MMC) alone versus MMC combined with adjunctive intracameral bevacizumab in patients with glaucoma, evaluating intraocular pressure (IOP) control, medication reduction, survival-defined surgical success, and postoperative complications.
Setting
Retrospective comparative cohort study conducted at Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom, a tertiary referral glaucoma centre.
Methods
Consecutive patients undergoing PreserFlo MicroShunt implantation between January 2020 and December 2022 were included. Eyes received MMC alone (n=180) or MMC plus intracameral bevacizumab (n=129). Primary outcomes were qualified (IOP 6–21 mmHg with ≥20% reduction) and complete (medication-free) success assessed by Kaplan–Meier survival analysis. Cox regression adjusted for baseline IOP, age, sex, and lens status. Pre-specified sensitivity analyses were performed stratified by lens status and restricted to primary open-angle glaucoma/ocular hypertension (POAG/OHT).
Results
A total of 309 eyes were analysed with mean follow-up of 21.4 months. Mean IOP reduced from 27.8±10.0 to 15.2±5.4 mmHg (MMC) and 27.2±10.4 to 14.5±4.4 mmHg (MMC+bevacizumab) at 24 months (p=0.342). Qualified success at 24 months was 65.3% vs 68.5% (p=0.723); complete success 53.2% vs 47.7% (p=0.409). Adjusted hazard ratios showed no treatment effect for qualified (HR 0.84, p=0.421) or complete success (HR 1.07, p=0.699). Sensitivity analyses confirmed robustness. Early sustained hypotony (8.5% vs 2.8%, p=0.035) and bleb leaks (3.9% vs 0%, p=0.012) were more frequent with bevacizumab.
Conclusions
PreserFlo MicroShunt implantation with MMC provides sustained IOP and medication reduction over 24 months. Adjunctive intracameral bevacizumab did not improve survival-defined surgical success and was associated with increased early postoperative complications. Routine bevacizumab use during PreserFlo implantation does not appear justified when adequate MMC is applied.