Précis: This study demonstrated that the Preserflo MicroShunt effectively lowered intraocular pressure in eyes with open-angle glaucoma; however, the reduction was less pronounced in highly myopic eyes than in non–highly myopic eyes. Purpose: To compare surgical outcomes between eyes with high myopia (HM) and non-HM in open-angle glaucoma (OAG) and to identify risk factors for surgical success. Methods: This retrospective study included 52 eyes (41 patients) with OAG that underwent Preserflo MicroShunt (PMS) implantation and were followed for 6 months. Eyes were categorized by axial length (AL) into non-HM (AL ≤26.5 mm) and HM (AL >26.5 mm) groups. Surgical success was defined as a ≥20% intraocular pressure (IOP) reduction and postoperative IOP ≤18 mmHg (criterion A), ≤15 mmHg (criterion B), or ≤12 mmHg (criterion C) without increased glaucoma medications. Kaplan–Meier analysis compared cumulative success rates, and Cox regression identified risk factors for failure. Results: Mean AL was 24.01±1.18 mm in non-HM and 30.26±2.30 mm in HM eyes ( P <0.001). IOP and medication use significantly decreased in both groups at all time points (all P <0.001). The non-HM group showed significantly lower IOP at 1 day and 1 week postoperatively ( P =0.037 and P =0.034), with no differences after 1 month. At 6 months, surgical success was significantly lower in HM eyes for criteria A and C ( P =0.009 and P =0.044). AL was the critical risk factor for surgical failure. No significant differences were found in adverse events between groups. Conclusions: PMS implantation effectively lowered IOP in both groups; however, surgical success was reduced in HM eyes, suggesting decreased short-term surgical stability.
Iemura et al. (Thu,) studied this question.