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PreserFlo MicroShunt® exposure: a case series
Roxane Bunod1, Mathieu Robin1, Juliette Buffault1,2
1Department of Ophthalmology III, Quinze-Vingts National Ophthalmology Hospital, 28 rue de Charenton, 75012, Paris, France.
Background:
PreserFlo® MicroShunt (PM) (also known as InnFocus® MicroShunt) is a subconjunctival stent implanted ab externo via a minimally invasive surgical procedure. The current indication is progressive, mild to moderate, open angle glaucoma uncontrolled on topical medications. According to the literature, adverse events are rare, mild and transient.
Case Presentation:
Two cases of stand-alone PreserFlo MicroShunt® implantation in patients with uncontrolled open-angle glaucoma are reported. Exposure occurred 7 days and 3 months respectively after implantation. These cases shared common features including preexisting blepharitis and the lack of a Tenon's flap. In both cases, removal of the device was required after several attempts at repair.
Conclusions:
PreserFlo MicroShunt® exposure is a potentially vision-threatening complication because of the risk of endophthalmitis. Potential risk factors include the absence of a Tenon's flap and pre-existing ocular surface inflammation. Ocular surface inflammation should be detected and treated prior to PM implantation. If a deficiency in Tenon's capsule is noted intraoperatively, close monitoring should be performed because of the higher risk of PM exposure.
Insights
PreserFlo MicroShunt (PM) exposure is a rare but serious complication for glaucoma patients. Pre-existing ocular surface inflammation and lack of a Tenon's flap increase the risk of this vision-threatening event.
Area of Science:
- Ophthalmology
- Glaucoma Surgery
- Medical Device Complications
Background:
- PreserFlo MicroShunt (PM) is a minimally invasive surgical device for open-angle glaucoma uncontrolled by medication.
- Adverse events associated with PM implantation are typically rare, mild, and transient.
Observation:
- Two cases of PreserFlo MicroShunt exposure are presented, occurring 7 days and 3 months post-implantation.
- Both cases involved patients with pre-existing blepharitis and lacked a Tenon's flap, necessitating device removal.
Findings:
- PreserFlo MicroShunt exposure is a potentially vision-threatening complication, carrying a risk of endophthalmitis.
- Absence of a Tenon's flap and pre-existing ocular surface inflammation are identified as potential risk factors.
Implications:
- Ocular surface inflammation should be treated before PM implantation.
- Close monitoring is crucial for patients with intraoperative Tenon's capsule deficiencies due to increased exposure risk.
