Comparative Study of Early Safety and Effectiveness Outcomes of the PreserFlo MicroShunt with and without an Intraluminal Suture Stent

Objective: To assess the early safety and effectiveness outcomes of the PreserFlo MicroShunt with and without an intraluminal suture stent.

Design: Multicenter observational retrospective study using data from the Fight Glaucoma Blindness registry.

Participants: A total of 183 eyes in 172 patients, with a mean age of 73 ± 14 years, who underwent PreserFlo MicroShunt surgery with/without intraluminal stent suture placement, and with at least 6 months of follow-up. Eyes were divided into 2 groups: stent (68 eyes) and no-stent (115 eyes).

Methods: Baseline and postoperative measurements of intraocular pressure (IOP), visual acuity (VA), number of glaucoma medications, and adverse events were recorded at 1, 3, and 6 months. Outcomes were compared between stent and no-stent groups using t tests for continuous variables and Fisher exact tests for categorical variables.

Main Outcome Measures: The primary outcome measures were the incidence of numerical hypotony (IOP ≤ 5 mmHg) and symptomatic hypotony (numerical hypotony plus ≥10 letters of VA loss) within 1 month, 1 to 3 months, and 3 to 6 months postoperatively. Secondary outcome measures included surgical success rates (defined as IOP ≤12, ≤15, ≤18, or ≤21 mmHg and ≥20% IOP reduction without hypotony and without additional glaucoma medications) and the need for secondary surgical interventions.

Results: In the first postoperative month, the stent group had significantly lower rates of numerical hypotony (24% vs. 44%; P = 0.007) and symptomatic hypotony (13% vs. 28%; P = 0.027) than the no-stent group. The rate of device revision, explant, or replacement with an alternative shunt was also significantly lower in the stent group (3 eyes; 4.4%) than in the no-stent group (17 eyes; 14.8%; P = 0.047). No significant differences in hypotony rates were observed in the later follow-up windows (1–3 and 3–6 months), nor were there significant differences in surgical success rates between the stent and no-stent groups at any time point.

Conclusions: The use of an intraluminal suture stent in PreserFlo MicroShunt surgery reduces the incidence of early hypotony without compromising surgical success. These findings suggest that routine use of intraluminal sutures may improve early postoperative safety.

*Author(s): JASON CHAMI, JEREMY C.K. TAN, DAVID MANNING, GEORGE KONG, JASON CHENG, HAMISH DUN, ANNA GALANOPOULOS, BRIAN CHUA, JOANNE THAI , MARK HASSALL, JAMIE E. CRAIG, MITCHELL LAWLOR.

Doi: 10.1016/j.ogla.2025.03.003

Link: https://www.sciencedirect.com/science/article/abs/pii/S2589419625000444

Clinical Paper of the Month manager: Rafael Correia Barão

Editors in Chief: Francesco Oddone, Manuele Michelessi