Sulcus Placement of PreserFlo Microshunt in Iridocorneal Endothelial Syndrome: A Case Report

Secondary angle-closure glaucoma associated with iridocorneal endothelial (ICE) syndrome can be challenging to manage. This report presents a novel case of sulcus placement of a PreserFlo Microshunt in a patient with ICE syndrome following the failure of previous trabeculectomy and medical therapy.

A 61-year-old patient with secondary angle-closure glaucoma due to ICE syndrome had uncontrolled intraocular pressures despite maximal medical therapy. They had a previous trabeculectomy, which failed following cataract surgery. Because of extensive peripheral anterior synechiae and risk of corneal decompensation, a PreserFlo Microshunt was placed in the sulcus. At the 18-month postoperative follow-up, intraocular pressure was well controlled without topical therapy.

This is the first reported case of a PreserFlo Microshunt implanted in the sulcus in ICE syndrome. Sulcus placement provides a viable alternative in pseudophakic patients with extensive peripheral anterior synechiae, helping to mitigate the risk of corneal decompensation while effectively controlling intraocular pressure.