Preserflo™ microshunt for the treatment of refractory childhood glaucoma: A case series study

We report the outcomes of five patients with pediatric glaucoma, who were treated with Preserflo™ microshunt surgery.

This prospective study included five consecutive patients who underwent Preserflo™ microshunt surgery at the Nagoya University Hospital. The main outcome measures evaluated in this study were mean intraocular pressure (IOP), number of glaucoma medications, and best corrected visual acuity (BCVA). Paired t-tests with Bonferroni correction were used to compare the baseline and follow-up periods, where p < 0.05 was considered statistically significant.

Average age at the time of surgery was 10 ± 4 years. Three patients had primary congenital glaucoma, one had Sturge-Weber syndrome, and one had juvenile open-angle glaucoma. Preoperative average IOP was 37.6 ± 4.7 mmHg. After microshunt surgery, IOP significantly decreased to 6.3 ± 1.2 mmHg in 1 day, 6.6 ± 1.7 mmHg in 1 week, 9.6 ± 6.1 mmHg in 1 month, 12.0 ± 7.4 mmHg in 3 months, 10.0 ± 5.2 mmHg in 6 months, 14.2 ± 8.7 mmHg in 9 months, and 10.5 ± 6.5 mmHg in 1 year (p < 0.01 for each paired t-test). One year postoperatively, we placed a Baerveldt glaucoma implant in case 1. No significant change was observed between the pre- and post-operative periods in BCVA. No postoperative complications, including choroidal detachment, shallow or flat anterior chamber, hypotony maculopathy, or conjunctival leak, were observed in this case series.

Microshunt surgery may be a useful option for treating glaucoma in pediatric patients, in whom trabeculotomy failed.