Abstract

BackgroundPreserFlo® MicroShunt (PM) (also known as InnFocus® MicroShunt) is a subconjunctival stent implanted ab externo via a minimally invasive surgical procedure. The current indication is progressive, mild to moderate, open angle glaucoma uncontrolled on topical medications. According to the literature, adverse events are rare, mild and transient.Case presentationTwo cases of stand-alone PreserFlo MicroShunt® implantation in patients with uncontrolled open-angle glaucoma are reported. Exposure occurred 7 days and 3 months respectively after implantation. These cases shared common features including preexisting blepharitis and the lack of a Tenon’s flap. In both cases, removal of the device was required after several attempts at repair.ConclusionsPreserFlo MicroShunt® exposure is a potentially vision-threatening complication because of the risk of endophthalmitis. Potential risk factors include the absence of a Tenon’s flap and pre-existing ocular surface inflammation. Ocular surface inflammation should be detected and treated prior to PM implantation. If a deficiency in Tenon’s capsule is noted intraoperatively, close monitoring should be performed because of the higher risk of PM exposure.

Highlights

  • PreserFlo® MicroShunt (PM) is a subconjunctival stent implanted ab externo via a minimally invasive surgical procedure

  • We report two cases of PM extrusion and review the literature concerning the risk factors and management of stent exposure following subconjunctival minimally invasive glaucoma surgery (MIGS) surgeries

  • Because of the absence of Tenon’s capsule, the conjunctiva exclusively was pulled over the PM and sutured back to the limbus using 8–0 PolysorbTM (Covidien, Dublin, Ireland) sutures made of LactomerTM

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Summary

Conclusions

PreserFlo MicroShunt® exposure is a potentially vision-threatening complication because of the risk of endophthalmitis. Potential risk factors include the absence of a Tenon’s flap and pre-existing ocular surface inflammation. Ocular surface inflammation should be detected and treated prior to PM implantation. If a deficiency in Tenon’s capsule is noted intraoperatively, close monitoring should be performed because of the higher risk of PM exposure

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