Abstract
INTRODUCTION: Glaucoma following corneal transplantation and artificial iris implantation represents a major therapeutic challenge, and data on optimal surgical management in such complex cases are scarce. CASE PRESENTATION: We report the case of a 28-year-old male with uncontrolled intraocular pressure (IOP) after penetrating keratoplasty and Morcher aniridia ring implantation. Despite maximally tolerated medical therapy, IOP remained elevated. PreserFlo MicroShunt implantation was performed successfully, leading to sustained IOP reduction without medications and preservation of graft clarity at 7-month follow-up. CONCLUSION: To our knowledge, this is the first reported case of PreserFlo MicroShunt implantation in a patient with combined keratoplasty and Morcher aniridia rings. This case highlights the potential role of PreserFlo as a viable option for IOP control in complex post-traumatic and postsurgical eyes. However, the findings represent a short-term (7-month) outcome, and the long-term efficacy requires further evaluation.