Iris Obstruction Following PRESERFLO Microshunt Implantation and Surgical Management

Area of Science:

• Ophthalmology
• Glaucoma Surgery
• Medical Device Complications

Background:

• Primary open-angle glaucoma (POAG) management often requires surgical intervention to lower intraocular pressure (IOP).
• Microshunt implantation, such as the PRESERFLO MicroShunt (PMS), offers a minimally invasive approach for IOP reduction.
• Potential complications, including lumen obstruction, require careful monitoring and management strategies.

Observation:

• A 56-year-old male with POAG developed elevated IOP (26 mmHg) in the right eye five months post-PMS implantation.
• Clinical examination revealed iris tissue obstructing the microshunt lumen as the cause of the IOP increase.
• The obstruction led to uncontrolled intraocular pressure, necessitating intervention.

Findings:

• Surgical intervention involved severing and removing iris fibers from the microshunt lumen entrance.
• Post-operative follow-up demonstrated a normalized IOP of 10 mmHg.
• The microshunt lumen was confirmed to be clear, indicating successful resolution of the obstruction.

Implications:

• This case highlights a specific complication of microshunt surgery: iris obstruction.
• Surgical removal of obstructing iris tissue is an effective management strategy for restoring microshunt patency and IOP control.
• The findings suggest that prompt surgical intervention can successfully address lumen obstruction without necessitating device explantation or repositioning.