Work

One-year clinical outcome of PreserFlo MicroShunt implantation versus trabeculectomy in patients with secondary open-angle glaucoma

Year: 2026

Type: article

Abstract: OBJECTIVE: To compare in detail the clinical outcome and safety of PreserFlo MicroShunt implantation versus trabeculectomy in patients with secondary open-angle glaucoma (SOAG). DESIGN/PARTICIPANTS: A retrospective study of patients with SOAG and uncontrolled intraocular pressure (IOP) who underwent PreserFlo MicroShunt implantation (PreserFlo) or trabeculectomy (TRAB) at the Medical University of Innsbruck. METHODS: We analyzed changes in IOP, use of IOP-lowering medications, complete surgical success (IOP ≤21 to ≤12 mm Hg and >6 mm Hg without medication), best-corrected visual acuity, and visual field outcomes up to 12 months postoperatively. RESULTS: Between 2014 and 2023, PreserFlo was performed in 85 eyes and TRAB in 55 eyes. Mean IOP decreased from 26.8 to 10.8 mm Hg (mean reduction 56%, 95% confidence interval 52-61%; p < 0.001) in the PreserFlo group and from 27.3 to 10.9 mm Hg (mean reduction 55%, 46-65%; p < 0.001) in the TRAB group. IOP was significantly lower in the PreserFlo group at 1-3 days and 1 week (p < 0.001 and p = 0.007, respectively). At 12 months, both groups showed similar rates of medication use (18.8% vs 11.4%; p = 0.334) and complete surgical success (e.g., ≤18 mm Hg: 76.8% vs 75.7%; p = 0.864). PreserFlo was associated with fewer needlings (hazard ratio 0.33; 0.12-0.90; p = 0.0031) and worse BCVA at month 12 (p = 0.036). CONCLUSIONS: Both PreserFlo and trabeculectomy significantly lowered IOP and reduced medication use over 12 months. PreserFlo was associated with fewer postoperative interventions, while TRAB yielded better visual acuity outcomes. Both procedures appear comparably safe and effective for treating SOAG.

Source: Canadian Journal of Ophthalmology

DOI: 10.1016/j.jcjo.2026.01.002