Functional assessment of the Preserflo MicroShunt implant in pigmentary glaucoma: 2 years follow-up

To evaluate the clinical outcomes of Preserflo MicroShunt (PMS) implantation with mitomycin C (MMC) in the management of pigmentary glaucoma (PG). Retrospective observational study. All consecutive patients diagnosed with PG who underwent PMS implantation with at least 24 months of follow-up were included. Primary outcomes included postoperative intraocular pressure (IOP), number of hypotensive medications, surgical success, defined as IOP < 18 mmHg with a reduction of ≥ 20% from baseline without the need for further surgery and no severe surgery-related complications. ‘Complete success’ was defined as achieving target IOP without medications; ‘qualified success’ allowed the use of medications. Fourteen eyes from 10 patients (mean age 60.8 ± 11.8 years) were included. Mean IOP was significantly reduced from 23.8 ± 6.0 mmHg at baseline to 14.9 ± 4 mmHg at 12 months and to 15.4 ± 2.7 at 24 months (both p < 0.001). The mean number of glaucoma medications per patient decreased from 2.9 ± 1 at baseline to 0.5 ± 0.8 at 12 months ( p = 0.002) and to 1 ± 0.9 at 24 months ( p = 0.003). At 24 months, 35.7% of patients ( n = 5) were medication-free. Overall success at 12 and 24 months was 71.4%, with complete success achieved in 50% at 12 months and 28.6% at 24 months. No sight-threatening complications were observed. No cases required bleb revision. Our results suggests that PMS is a safe and effective surgical option for the treatment of PG.