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Bleb-related infection associated with an intraluminal stent suture after PreserFlo MicroShunt implantation: a case
Masashi Nishigaki1, Atsuya Miki1,2, Chiaki Nogawa1
1Aichi Medical University, Aichi, Japan.
Purpose:
The PreserFlo MicroShunt (PMS) is a glaucoma drainage device designed to reduce intraocular pressure (IOP) with fewer complications than conventional filtering surgery. An intraluminal stent suture can prevent early postoperative hypotony; however, a potential infection risk exists. We report a rare case of bleb-related infection associated with an intraluminal stent suture in the PMS.
Observation:
An 80-year-old man with secondary glaucoma due to bilateral cytomegalovirus anterior uveitis underwent bilateral PMS implantation with a 10-0 nylon intraluminal stent suture. The stent was removed from the right eye 1 month postoperatively but retained in the left eye because the IOP remained stable. At 3.5 months postoperatively, the left eye developed eyelid swelling, ocular pain, conjunctival hyperemia, and anterior chamber inflammation without bleb leakage. Infection related to the stent suture was suspected. After stent removal, suture culture grew Streptococcus agalactiae. Intensive topical and intracameral antibiotic therapy resolved the inflammation within 2 weeks. Transient hypotony and choroidal detachment occurred after removal but resolved conservatively, and the IOP stabilized.
Conclusion And Importance:
Intraluminal stent sutures may effectively prevent early postoperative hypotony after PMS implantation, but their indication should be carefully considered while balancing the risks of hypotony and infection. Early stent removal and careful postoperative monitoring are essential.
