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Scleral bridging technique for preventing PreserFlo microshunt exposure: A case report
Shunsuke Nakakura1, Yuki Nagata1, Yasuko Fujisawa1
1Department of Ophthalmology, Saneikai Tsukazaki Hospital, Himeji, Japan.
Introduction:
The use of the PreserFlo microshunt is gaining popularity owing to its ease of implantation and reduced need for postoperative intervention compared to conventional trabeculectomy.
Patient Concerns:
However, microshunt exposure remains a severe complication of PreserFlo surgery, particularly in patients with a thin Tenon capsule and conjunctiva. However, the actual thickness and intensity of the Tenon capsule or conjunctiva can be confirmed only during surgery.
Diagnosis:
Exfoliation glaucoma with previous several glaucoma surgeries with thinner Tenon capsule or conjunctiva.
Interventions:
We performed PreserFlo implantation with a surgical technique to recover a thin Tenon capsule and conjunctiva by creating a half-thickness rectangular scleral flap under the shunt and covering it over the microshunt until the distal part, similar to the bridge.
Outcomes:
The patient had better intraocular pressure control with positive cosmetic appearance using this technique.
Conclusion:
This technique will be beneficial for both preventing exposure and holding down the top, in addition to improving cosmetic appearance.
