Postoperative Period and Results after Preserflo Implantation in Glaucoma Patients

Abstract

“Efficacy and Safety of PreserFlo MicroShunt Implantation in Glaucoma Patients” reviews current clinical evidence on the PreserFlo MicroShunt as a surgical option for lowering intraocular pressure (IOP) in glaucoma. The study summarizes data from clinical trials and meta-analyses published between 2018 and 2025, comparing the device’s efficacy and safety with conventional trabeculectomy.

Glaucoma is described as a major cause of irreversible blindness, and reducing IOP remains the only proven method to slow disease progression. When medications and laser treatment fail, surgery is indicated. Trabeculectomy, although effective, is associated with high complication rates. The PreserFlo MicroShunt offers a less invasive alternative that maintains pressure control with fewer risks.

The device is an 8.5 mm-long biocompatible SIBS polymer tube with a 70 µm lumen, implanted under the conjunctiva using an ab externo technique. Mitomycin-C (MMC) is applied to reduce postoperative fibrosis. Its fixed lumen diameter provides controlled aqueous outflow and minimizes hypotony risk.

The review includes seven clinical studies and two meta-analyses, covering about 1,000 eyes. Across studies, PreserFlo implantation reduced IOP by 35–45%, lowering mean pressures from 22–24 mmHg to 12–15 mmHg. The need for topical medication decreased by 70–80%, with most patients remaining medication-free at one year. Long-term data show sustained IOP control for up to five years.

The most frequent complication was transient hypotony, occurring in about 20% of cases and resolving spontaneously. Serious complications, such as chronic hypotony, infection, or endophthalmitis, were rare (<1%). Compared with trabeculectomy, PreserFlo produced slightly higher final IOP but with fewer postoperative adverse events, including lower rates of bleb leakage and shallow anterior chamber.

The PreserFlo MicroShunt achieves meaningful and sustained pressure reduction with a favorable safety profile. While trabeculectomy remains more effective in achieving very low IOP levels, PreserFlo offers a safer and more predictable option for patients with moderate to advanced glaucoma. However, an emphasis should be placed on the need for longer follow-up and standardized surgical protocols to confirm long-term durability and cost-effectiveness.