Transconjunctival Compression Sutures for Postoperative Hypotony After PRESERFLO MicroShunt Revision: A Case Report

This is a case in which postoperative hypotony following bleb revision after PRESERFLO^TM MicroShunt (MicroShunt) implantation in exfoliation glaucoma was successfully managed using transconjunctival compression sutures. An 82-year-old man with exfoliation glaucoma underwent MicroShunt implantation in the right eye for uncontrolled intraocular pressure (IOP). Due to bleb failure, open bleb revision with mitomycin C was subsequently performed. On postoperative day 14, severe hypotony with circumferential kissing choroidal detachment developed, and transconjunctival compression sutures were placed on the distal tube segment posterior to the MicroShunt fin to reduce aqueous outflow. Following the procedure, IOP gradually increased from 6 mmHg to 10 mmHg, accompanied by complete resolution of the choroidal detachment. At two months of follow-up, IOP remained stable without glaucoma medications. Transconjunctival compression suturing may represent a simple and minimally invasive treatment option for managing postoperative hypotony after MicroShunt implantation.