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Reinterventions After PreserFlo Implantation: A Report on Results in Clinical Practice
Beatriz Puerto1,2,3, Cristina López-Caballero1, Carmen Sánchez-Sánchez1
1Clínica Rementería, Madrid, Spain.
Background:
The PreserFlo MicroShunt is an effective surgical procedure for intraocular pressure (IOP) control in glaucoma. This study focuses on the rate of reinterventions after PreserFlo implantation, as well as exploring possible risk factors for reintervention.
Methods:
This retrospective study included all patients undergoing PreserFlo implantation in our center between March 2021 and March 2023. Surgery was performed as per the manufacturer's recommendations and combined with mitomycin C (MMC) application (0.2 mg/mL, 2 min). Clinical data before the surgical procedure, surgical reinterventions, IOP, the use of hypotensive drugs, and the results of visual field testing were recorded and analyzed.
Results:
91 eyes of 84 patients undergoing PreserFlo implantation were included. 48 eyes had primary open-angle glaucoma (POAG), 23 eyes pseudoexfoliation glaucoma, and the rest myopic, pigmentary or secondary glaucoma. At least one additional surgical procedure was required in 31 eyes (34.1%); 13 eyes required more than one procedure. Approximately 45% of the additional procedures had to be performed in the first 3 months after PreserFlo implantation. The additional procedures performed were 35 bleb revision surgeries, four vitrectomies, eight iStent implantations, four conjunctival sutures due to bleb leak, five nonpenetrating deep sclerotomies, and two PreserFlo tube repositioning surgeries. There was a statistically significant higher rate of reinterventions in eyes with pigmentary or pseudoexfoliative glaucoma (14/26, 53.8%) compared to eyes with POAG (12/48, 25%) (p=0.013, chi square). The rate of reintervention was higher in eyes using ≥ 3 drugs before surgery (29/69 eyes, 42.0%) than in eyes treated with ≤ 2 drugs (2/22 eyes, 9%) (p=0.005, chi square).
Conclusions:
Surgical reinterventions were required in a third of the eyes implanted with PreserFlo. Reintervention rate was higher in eyes treated with ≥ 3 drugs. Surgeons should consider adding additional measures to prevent fibrosis when implanting PreserFlo in these eyes.
