Surgical outcomes of the SIBS microshunt in pediatric glaucoma: a retrospective study.

OBJECTIVE

To assess the surgical outcomes of the ab externo SIBS microshunt (PreserFlo MicroShunt; Glaukos Corporation, Aliso Viejo, CA) in the treatment of pediatric glaucoma.

METHODS

This single-centre retrospective case series was conducted at a tertiary pediatric care centre in Montreal, Ontario. All pediatric patients (<18 years of age) with primary or secondary glaucoma, who underwent SIBS microshunt implantation between January 2022 and April 2025, were included. The primary endpoint was surgical success (intraocular pressure 6-21 mm Hg), defined as complete without glaucoma medications and qualified with medications but without further surgery. Secondary outcomes included postoperative IOP, number of glaucoma medications, and postoperative complications.

RESULTS

Eighteen eyes from 14 patients were included. Mean age was 13.7 ± 4.2 years. Mean follow-up was 15.3 ± 9.2 months. Across all eyes, mean intraocular pressure decreased from 28.3±4.5 mm Hg preoperatively to 19.1 ± 7.7 mm Hg at 12 months (p = .02). The mean number of glaucoma medications decreased from 5.1 ± 0.6 preoperatively to 1.6 ± 2.2 at 12 months (p = .002). Complete surgical success rates were 61% at 6 months and 49% at 12 months, while qualified success rates were 67% and 55%, respectively. Postoperative complications occurred in 2 eyes: malignant glaucoma (n = 1) and choroidal and serous retinal detachment (n = 1).

CONCLUSIONS

In pediatric glaucoma, the ab externo SIBS microshunt demonstrated reasonable 1-year surgical success rates with few complications, supporting its potential as a therapeutic alternative in selected cases within this population. Long-term, prospective studies are warranted to further assess its durability and safety in this population.