Intraoperative optical coherence tomography for Ab externo PreserFlo MicroShunt in glaucoma surgery

PurposeThis study aims to introduce an innovative surgical technique for facilitating the insertion and precise positioning of the PreserFlo MicroShunt (PMS) using intraoperative optical coherence tomography (iOCT).MethodsiOCT was employed to determine the transscleral route, entry point into the anterior chamber (AC), trajectory of the PMS within the AC, and final intracameral and scleral positioning of the PMS. Intra- and postoperative outcomes and complications were evaluated.ResultsThis retrospective study included nine eyes of nine consecutive glaucoma patients who underwent PMS implantation using the new technique. All patients showed a significant reduction in intraocular pressure, without notable complications. In some cases, iOCT identified initial misplacements, enabling immediate intraoperative adjustments and successful repositioning, ensuring precise and safe implantation in all cases.ConclusionThis innovative application of iOCT offers a means to refine the PMS implantation technique by enhancing intraoperative visualization and positioning accuracy. The integration of iOCT has the potential to enhance the surgical techniques of experienced surgeons as well as to improve the training of junior practitioners.