Outcomes of PreserFlo MicroShunt in Japanese Glaucoma Patients With a History of Glaucoma Surgery.

PRÉCIS: PreserFlo MicroShunt significantly reduced intraocular pressure and medication burden in Japanese eyes with prior glaucoma surgery, showing a favorable safety profile and offering a viable option for further surgical intervention regardless of previous procedure type.

PURPOSE: To evaluate the efficacy and safety of the PreserFlo MicroShunt (PMS) in Japanese patients with a history of at least one glaucoma surgery.

METHODS

This retrospective study included Japanese glaucoma patients who underwent PMS implantation with adjunctive mitomycin C between October 2022 and July 2023, with or without simultaneous cataract surgery. All eyes had undergone at least one prior glaucoma procedure. On the basis of surgical history, patients were categorized into 2 groups: group 1 (filtration surgery) and group 2 (ab interno reconstruction surgery or laser trabeculoplasty). Primary outcomes included intraocular pressure (IOP), medication score, and logMAR visual acuity (VA) over 12 months, analyzed using a mixed-effects model. Postoperative complications and additional interventions were extracted from medical records.

RESULTS

Group 1 included 23 eyes (mean baseline IOP: 23.1 mm Hg, 2.6 medications), and group 2 included 32 eyes (mean baseline IOP: 21.9 mm Hg, 4.2 medications). At 12 months, mean IOP was reduced by 44.6% in group 1 and 37.1% in group 2, with both groups showing significant IOP reductions (P < 0.001). Medication scores were significantly reduced at all time points in both groups (P < 0.001). No significant changes in VA or vision-threatening complications were observed.

CONCLUSIONS

PMS implantation significantly lowered IOP and reduced the need for medications in eyes with a history of glaucoma surgery, regardless of prior conjunctival manipulation. These findings support the role of PMS as a safe and effective option for further surgical intervention in this population.