Optimizing Early Postoperative Outcomes: The Role of Intraluminal PRESERFLO™ Stenting

Authors

  • Telma Machado Ophthalmology Department, Hospitais da Universidade de Coimbra, Unidade Local de Saúde de Coimbra, Coimbra, Portugal; Clinical Academic Center of Coimbra, Hospital Pediátrico de Coimbra, Unidade Local de Saúde de Coimbra, Coimbra, Portugal https://orcid.org/0009-0001-0727-4886
  • Jorge Simão Ophthalmology Department, Hospitais da Universidade de Coimbra, Unidade Local de Saúde de Coimbra, Coimbra, Portugal; Clinical Academic Center of Coimbra, Hospital Pediátrico de Coimbra, Unidade Local de Saúde de Coimbra, Coimbra, Portugal
  • Tatiana Queirós Ophthalmology Department, Hospitais da Universidade de Coimbra, Unidade Local de Saúde de Coimbra, Coimbra, Portugal; Clinical Academic Center of Coimbra, Hospital Pediátrico de Coimbra, Unidade Local de Saúde de Coimbra, Coimbra, Portugal
  • Pedro Faria Ophthalmology Department, Hospitais da Universidade de Coimbra, Unidade Local de Saúde de Coimbra, Coimbra, Portugal; Clinical Academic Center of Coimbra, Hospital Pediátrico de Coimbra, Unidade Local de Saúde de Coimbra, Coimbra, Portugal
  • João Bernardes Ophthalmology Department, Hospitais da Universidade de Coimbra, Unidade Local de Saúde de Coimbra, Coimbra, Portugal; Clinical Academic Center of Coimbra, Hospital Pediátrico de Coimbra, Unidade Local de Saúde de Coimbra, Coimbra, Portugal https://orcid.org/0009-0001-0727-4886

DOI:

https://doi.org/10.48560/rspo.38369

Keywords:

Glaucoma Drainage Implants, Glaucoma/surgery, Intraocular Pressure, Ocular Hypotension, Postoperative Care, Stents

Abstract

INTRODUCTION: The PRESERFLOTM MicroShunt (PMS) is a safe and effective implant for lowering intraocular pressure (IOP) in patients with different types of glaucoma. One of the most common early complications after PMS implantation is hypotony, therefore the use of preventive measures in high-risk patients is advisable.

We aimed to evaluate the efficacy of intraluminal stenting of PMS in preventing hypotony during the early postoperative period.

METHODS: Retrospective comparative cohort study on consecutive patients who underwent PMS implantation with or without intraluminal stenting at Unidade Local de Saude de Coimbra, between May 2023 and July 2024. The primary outcome was the incidence of hypotony at one week postoperative. Secondary outcomes included overall success and frequency of complications.

RESULTS: Eighty-two eyes (77 patients) with glaucoma underwent PMS implantation. Of these, 21 eyes underwent stenting of the PMS, while 61 eyes were implanted with a non-stented PMS. The stent PMS group was characterized by a higher incidence of high myopia (33.3%) and monocular vision (52.4%) compared to the non-stent group (3.3% and 23.0% respectively) (p< 0.001 and p = 0.012). One day after surgery, the mean IOP dropped to 7.8±3.8 mmHg in the non-stent group, and 12.3±5.1 mmHg in the stenting group (p< 0.001). After one week of surgery, the mean IOP was 10.4±5.6 mmHg in the non-stent group and 15.1±8.4 mmHg in the stenting PMS group (p = 0.026). Hypotony occurred in twenty-eight eyes (45.9%) in the non-stent PMS group and five (23.8%) in the stenting PMS group (p > 0.05). A shallow anterior chamber occurred in six eyes in the non-stent PMS group; four of them were associated with choroidal effusion. No cases of shallow anterior chamber or choroidal effusion were observed in the stenting PMS group. Overall surgical success at 3 months follow-up was similar between both groups.

CONCLUSION: In the early follow-up period, intraluminal stenting with 10.0 nylon of the PMS effectively limits the aqueous flow and controls the IOP while reducing postoperative hypotony. Yet, despite stenting, hypotony was still observed in our study, suggesting that aqueous humor leakage alongside the shunt, the extent of PMS occlusion, and population characteristics (age-influencing fibrosis) may contribute to hypotony.

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Published

2026-07-11

How to Cite

Machado, T., Simão, J., Queirós, T., Faria, P., & Bernardes, J. (2026). Optimizing Early Postoperative Outcomes: The Role of Intraluminal PRESERFLO™ Stenting. Revista Sociedade Portuguesa De Oftalmologia. https://doi.org/10.48560/rspo.38369

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