OUR EXPERIENCE WITH PRESERFLO MICROSHUNT IMPLANTATION SURGERY FOR PRIMARY OPEN-ANGLE GLAUCOMA

Abstract

Drainage devices represent an important advancement in glaucoma surgery, offering effective intraocular pressure (IOP) reduction with reduced surgical trauma and fewer postoperative complications. The PRESERFLOTM MicroShunt is a minimally invasive drainage device designed to enhance aqueous humor outflow. Although short- term outcomes are promising, data on its comparative efficacy with conventional surgical techniques remain limited.

Purpose – to evaluate the efficacy of microshunt implantation as a standalone IOP-lowering procedure in comparison with the standard non-penetrating deep sclerectomy (NPDS) technique performed according to the Fedorov-Kozlov method.

Material and methods
This open-label prospective study included 16 patients with primary open-angle glaucoma (POAG), including refractory cases, who underwent primary glaucoma surgery. Patients were divided into two groups: Group I (n = 8) underwent PRESERFLOTM MicroShunt implantation with Mitomycin C, and Group II (n = 8) underwent NPDS. Baseline demographic and clinical characteristics were comparable between groups (p > 0.05). Patients were followed for 12 months. Postoperative evaluation included best-corrected visual acuity (BCVA), perimetry, IOP measurement, slit-lamp examination, gonioscopy, fundus examination, anterior segment Optical Coherence Tomography (OCT), and ultrasound biomicroscopy (UBM).

Results
In Group I, mean IOP decreased from 31.0 ± 3.7 mmHg preoperatively to 9.4 ± 1.8 mmHg on day 1, stabilizing at 16.3 ± 4.1 mmHg after 1 year. In Group II, IOP decreased from 29.0 ± 4.1 mmHg to 16.5 ± 2.8 mmHg on day 1 and increased to 19.6 mmHg at 1 year. No patients required hypotensive medication during follow-up. Two NPDS patients (25%) required additional laser intervention. Visual acuity, perimetric indices, and optic nerve head parameters remained stable in both groups. No intraoperative or postoperative complications were observed.

Conclusion
PRESERFLOTM MicroShunt implantation demonstrated superior IOP control, a favorable safety profile, and reduced need for additional interventions compared with NPDS over a 1-year follow-up. This method may be recommended for patients with refractory POAG; however, larger studies with longer follow-up are required to confirm long-term efficacy and cost-effectiveness.