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PreserFlo MicroShunt and trabeculectomy show similar IOP reduction in secondary open-angle glaucoma

Ophthalmology 360

Key Takeaways

  1. PreserFlo and trabeculectomy achieved similar, substantial IOP reductions at 12 months
  2. Surgical success rates and medication use were comparable between the two procedures.
  3. PreserFlo required fewer postoperative interventions, while trabeculectomy had better visual acuity outcomes.

PreserFlo MicroShunt and trabeculectomy produced nearly identical intraocular pressure (IOP) reductions and surgical success rates in patients with secondary open-angle glaucoma at 12 months, with PreserFlo requiring fewer postoperative interventions but showing worse visual acuity outcomes, according to a study.

The analysis included 140 eyes with 85 undergoing PreserFlo implantation and 55 receiving trabeculectomy.

Mean IOP decreased from 26.8 to 10.8 mm Hg in the PreserFlo group and from 27.3 to 10.9 mm Hg in the trabeculectomy group (56% and 55% reductions, respectively; both P < 0.001). Identical intraocular pressure was significantly lower in the PreserFlo group during the early postoperative period at 1–3 days and at 1 week.

At 12 months, medication use was similar between groups (18.8% for PreserFlo vs 11.4% for trabeculectomy; P = 0.334). Rates of complete surgical success were also comparable, including success defined as IOP ≤18 mm Hg (76.8% vs 75.7%; P = 0.864).

PreserFlo was associated with fewer postoperative needling procedures (hazard ratio 0.33; P = 0.0031), while BCVA was worse in the PreserFlo group at 12 months (P = 0.036).

Both procedures significantly lowered IOP and reduced the need for medication over 1 year, with similar overall safety and effectiveness profiles in patients with secondary open-angle glaucoma.

Reference
Rauchegger T, Seifert F, Krause SM, et al. One-year clinical outcome of PreserFlo MicroShunt implantation versus trabeculectomy in patients with secondary open-angle glaucoma. Can J Ophthalmol. 2026;S0008-4182(26)00002-5. doi: 10.1016/j.jcjo.2026.01.002. Epub ahead of print. PMID: 41620201.

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