Three- And Six-Month Intraocular Pressure Outcomes After Combined Cataract Surgery And Preserflo Microshunt Implantation Versus Standalone Microshunt Implantation
Published 2026 - 44th Congress of the ESCRS
Reference: PP27.09 | Type: Free paper | DOI: 10.82333/93jz-9j77
Authors: Dr Carmen Gruzei* 1 , Ms Alessia Merenda 1 , Ms Julia Franzen 2 , Prof. Dr Yosuf El-Shabrawi 1
1Ophthalmology Department,Klinikum Klagenfurt,Klagenfurt,Austria;Medical University Graz,Graz,Austria, 2Ophthalmology Department,Klinikum Klagenfurt,Klagenfurt,Austria
Purpose
While the efficacy of PreserFlo MicroShunt implantation as a standalone procedure is well established, evidence regarding its combination with phacoemulsification remains limited. In contrast to trabeculectomy, where combined surgery may result in worse outcomes, it is unclear whether concomitant cataract surgery influences the pressure-lowering effect of the PreserFlo MicroShunt. This question is clinically relevant for surgical planning and patient counseling.
Setting
Prospective cohort study conducted at a tertiary care center. Patients undergoing either combined surgery (PreserFlo MicroShunt implantation with phacoemulsification) or PreserFlo MicroShunt implantation alone were included.
Methods
Twenty-nine eyes undergoing combined surgery were compared with 29 eyes receiving PreserFlo implantation alone. Included were patients with PEG, PDG, NTG, or POAG and insufficient medical intraocular pressure (IOP) control without prior glaucoma surgery. All patients in the standalone group were pseudophakic. IOP was measured preoperatively and at 3 and 6 months postoperatively. All 58 eyes completed 3-month follow-up; 20 per group completed 6 months. Postoperative needling rates were also assessed.
Results
In the combined group (n=29), mean IOP decreased from 21.86 ± 6.03 mmHg to 11.34 ± 5.97 mmHg at 3 months. In the standalone group (n=29), IOP decreased from 21.10 ± 8.01 mmHg to 9.62 ± 3.17 mmHg. Reductions were significant in both groups (p < 0.001) without between-group differences (p > 0.05). At 6 months (n=20 per group), IOP decreased from 26.85 ± 9.83 to 13.60 ± 5.21 mmHg (−41%) in the combined group and from 24.15 ± 8.34 to 10.85 ± 3.91 mmHg (−52%) in the standalone group. No significant between-group difference was observed.
Conclusions
PreserFlo MicroShunt implantation achieved an IOP reduction greater than 20% in the majority of patients, including those undergoing combined surgery. No statistically significant difference in pressure reduction was detected between groups. However, the lower percentage reduction in the combined group may suggest a trend toward a slightly less pronounced pressure-lowering effect when combined with phacoemulsification.