Abstract
PURPOSE: We report the initial outcomes, early complications, and management of PreserFlo MicroShunt (Santen Pharmaceutical Co., Ltd., Osaka, Japan) implantation in complicated glaucoma cases. METHODS: This was a retrospective study. RESULTS: A case series of 12 patients with various glaucoma etiologies underwent PreserFlo MicroShunt surgery at Hospital Canselor Tuanku Muhriz, Kuala Lumpur, Malaysia, from September 2022 to June 2023. Best-corrected visual acuity (BCVA), intraocular pressure (IOP), IOP-lowering medications, and postoperative complications were assessed. All procedures were augmented with intraoperative mitomycin C (0.2 mg/mL). Among the 12 patients (eight males, four females), five (42%) had primary open-angle glaucoma (OAG), five (42%) had secondary OAG, and one (8%) each had ocular hypertension and primary angle closure. Postoperatively, all patients except one showed significant IOP and medication reduction. Mean IOP decreased from 23.75 ± 8.82 to 15.67 ± 10.18 mmHg (34% reduction, p < 0.001), and mean IOP-lowering medications reduced from 4.58 to 0.08 (98% reduction, p < 0.001). Complications included wipeout syndrome due to hypotony (8%) and overfiltration hypotony (16%), with one requiring surgical revision and later a glaucoma drainage device. CONCLUSION: Our early results suggest PreserFlo MicroShunt is effective in lowering IOP and medications, but is associated with complications.