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Surgical outcomes of the SIBS microshunt in pediatric glaucoma: a retrospective study
Edmond Sandouk1, Kenan Bachour1, Louis-Étienne Marcoux2
1Division of Ophthalmology, Department of Surgery, CHU Sainte-Justine, Montreal, QC; Department of Ophthalmology, Centre Hospitalier de l'Université de Montréal, Montreal, QC; Department of Ophthalmology, Faculty of Medicine, Université de Montréal, Montreal, QC.
Objective:
To assess the surgical outcomes of the ab externo SIBS microshunt (PreserFlo MicroShunt; Glaukos Corporation, Aliso Viejo, CA) in the treatment of pediatric glaucoma.
Methods:
This single-centre retrospective case series was conducted at a tertiary pediatric care centre in Montreal, Ontario. All pediatric patients (<18 years of age) with primary or secondary glaucoma, who underwent SIBS microshunt implantation between January 2022 and April 2025, were included. The primary endpoint was surgical success (intraocular pressure 6-21 mm Hg), defined as complete without glaucoma medications and qualified with medications but without further surgery. Secondary outcomes included postoperative IOP, number of glaucoma medications, and postoperative complications.
Results:
Eighteen eyes from 14 patients were included. Mean age was 13.7 ± 4.2 years. Mean follow-up was 15.3 ± 9.2 months. Across all eyes, mean intraocular pressure decreased from 28.3±4.5 mm Hg preoperatively to 19.1 ± 7.7 mm Hg at 12 months (p = .02). The mean number of glaucoma medications decreased from 5.1 ± 0.6 preoperatively to 1.6 ± 2.2 at 12 months (p = .002). Complete surgical success rates were 61% at 6 months and 49% at 12 months, while qualified success rates were 67% and 55%, respectively. Postoperative complications occurred in 2 eyes: malignant glaucoma (n = 1) and choroidal and serous retinal detachment (n = 1).
Conclusions:
In pediatric glaucoma, the ab externo SIBS microshunt demonstrated reasonable 1-year surgical success rates with few complications, supporting its potential as a therapeutic alternative in selected cases within this population. Long-term, prospective studies are warranted to further assess its durability and safety in this population.
