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Primary PreserFlo MicroShunt Versus Trabeculectomy: Effectiveness and Safety in the Real World
Anoushka N Kothari1, Graham A Lee1,2
1Mayne Academy of Surgery, University of Queensland, Brisbane, QLD 4006, Australia.
Journal of Clinical Medicine
|November 13, 2025
Summary
PreserFlo MicroShunt (PF) and trabeculectomy effectively manage glaucoma by lowering intraocular pressure (IOP). PF offers faster inflammation resolution and less hypotony, while trabeculectomy shows a trend toward greater IOP reduction.
Area of Science:
- Ophthalmology
- Surgical Innovation
- Glaucoma Management
Background:
- Trabeculectomy is the standard glaucoma surgery but carries risks of serious complications.
- The PreserFlo MicroShunt (PF) offers a less invasive surgical option for glaucoma management.
- Comparing the safety and efficacy of PF against trabeculectomy is crucial for surgical decision-making.
Purpose of the Study:
- To compare the effectiveness and safety of the PreserFlo MicroShunt (PF) versus trabeculectomy for glaucoma treatment.
- To evaluate intraocular pressure (IOP) reduction, medication usage, and complication rates between the two surgical methods.
- To assess visual acuity and post-operative recovery metrics in patients undergoing PF or trabeculectomy.
Main Methods:
- Retrospective cohort analysis of 95 eyes (48 PF, 47 trabeculectomy) from a single Australian private practice.
- Data collected from November 2017 to January 2024, utilizing Inverse Probability of Treatment Weighting (IPTW) for covariate adjustment.
- Weighted regression and Cox proportional hazards models were employed to estimate treatment effects on primary and secondary outcomes.
Main Results:
- Both PF and trabeculectomy significantly reduced IOP and medication needs at 12 months, with no statistically significant difference between groups.
- Qualified success rates were comparable (74.9% PF vs. 72.5% trabeculectomy).
- PF demonstrated a lower incidence of early hypotony (when stented) and faster post-operative inflammation resolution (HR: 6.3, p < 0.001), while trabeculectomy showed a non-significant trend towards lower IOP and fewer revisions.
Conclusions:
- Both PreserFlo MicroShunt and trabeculectomy are effective glaucoma surgical options.
- PF is a less invasive procedure associated with reduced early hypotony and quicker inflammation recovery.
- Further long-term studies and enhanced anti-fibrotic strategies are needed to optimize glaucoma surgical outcomes.
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