We describe a rare case of tube obstruction caused by blood clots following PreserFlo MicroShunt (PMS) surgery and its subsequent management. A 64-year-old male patient with bilateral advanced exfoliation glaucoma underwent PMS surgery on the right eye. Tube obstruction was observed at 2 days postoperatively. Intraocular pressure (IOP) increased to 26 mmHg because of tube occlusion caused by blood clots at the tube tip. The occlusion was surgically released to free the lumen, and the IOP rapidly decreased to 7 mmHg. Uncontrolled IOP caused by blood clots obstructing the tube post-PMS surgery can be resolved by surgical intervention without the need of tube reinsertion. Careful monitoring of the tube tip is required when hyphema occurs during the postoperative period of PMS surgery.
Iwasaki et al. (2026) studied this question.