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Published on: February 2, 2015
Incidence and clinical features of malignant glaucoma after Preserflo MicroShunt implantation
Yusuke Koga1, Hiroki Mieno2, Kazuhiko Mori1,3
1Department of Ophthalmology, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Hirokoji-agaru, Kawaramachi-dori, Kamigyo-ku, Kyoto, 602-0841, Japan.
Purpose:
To investigate the incidence and clinical characteristics of malignant glaucoma (MG) following Preserflo MicroShunt (PMS) implantation.
Study Design:
Retrospective multicenter cohort study METHODS: We investigated 957 consecutive eyes that underwent PMS implantation between August 2022 and May 2025. In all eyes, patient age, sex, glaucoma subtype, preoperative intraocular pressure (IOP), medication score, axial length (AL), and use of intraluminal suture stenting (ISS) were examined. We identified cases in which MG developed postoperatively and compared age, preoperative IOP, medication score, and AL between the MG and non-MG groups. The timing of MG onset and treatment outcomes were also evaluated. After Bonferroni correction, the adjusted significance level was set at P<0.0125 (0.05/4).
Results:
MG occurred in 4 eyes (0.42%) of 2 men and 2 women, with a median age of 85.5 years (interquartile range [IQR], 84-90 years). All eyes were diagnosed with exfoliation glaucoma (XFG). Patients in whom MG developed were significantly older (P=0.006) and had a significantly higher preoperative IOP (P=0.006) than those without MG. No significant differences in AL or medication score were observed between the groups. MG developed on postoperative days 2, 3, and 4 in 3 eyes without ISS. In 1 case with ISS, MG occurred 3 days after ISS removal, but not during ISS placement. All MG cases were successfully treated with irido-zonulo-hyaloido-vitrectomy, with or without pars plana vitrectomy.
Conclusions:
Although rare, MG can occur in the early postoperative period after PMS implantation, particularly in older patients with a high preoperative IOP.
Insights
Malignant glaucoma (MG) is a rare complication after Preserflo MicroShunt (PMS) surgery. Older patients with high preoperative intraocular pressure (IOP) are at increased risk for this condition.
Area of Science:
- Ophthalmology
- Glaucoma Surgery
- Medical Device Research
Background:
- Preserflo MicroShunt (PMS) implantation is a surgical option for glaucoma management.
- Malignant glaucoma (MG) is a severe form of angle-closure glaucoma.
- Understanding complications after novel surgical devices is crucial for patient safety.
Purpose of the Study:
- To determine the incidence of malignant glaucoma (MG) after Preserflo MicroShunt (PMS) implantation.
- To describe the clinical characteristics of patients who develop MG post-PMS.
Main Methods:
- Retrospective multicenter cohort study of 957 eyes undergoing PMS implantation.
- Analysis of patient demographics, glaucoma type, preoperative intraocular pressure (IOP), medication score, axial length (AL), and intraluminal suture stenting (ISS) use.
- Comparison of characteristics between eyes that developed MG and those that did not.
Main Results:
- Malignant glaucoma (MG) occurred in 0.42% of eyes (4 eyes).
- MG was more common in older patients (median age 85.5 years) with higher preoperative IOP.
- All cases of MG were successfully treated with surgical intervention.
Conclusions:
- Malignant glaucoma (MG) is a rare but potential early postoperative complication of Preserflo MicroShunt (PMS) implantation.
- Older age and elevated preoperative IOP are risk factors for developing MG after PMS.
- Prompt surgical treatment is effective for managing post-PMS malignant glaucoma.
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