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Case Reports
. 2021 Dec 8:25:101238.
doi: 10.1016/j.ajoc.2021.101238. eCollection 2022 Mar.

Endothelial cell loss 5 years after Preserflo MicroShunt implantation: About two cases

Chloé Chamard  1   2 , Sirine Hammoud  3 , Elisa Bluwol  3 , Yves Lachkar  3
Affiliations
Case Reports

Endothelial cell loss 5 years after Preserflo MicroShunt implantation: About two cases

Chloé Chamard et al. Am J Ophthalmol Case Rep. .

Abstract

Purpose: Preserflo MicroShunt is a minimally-invasive glaucoma drainage micro-tube used to shunt aqueous humor from the anterior chamber to the subtenon space. The safety of the procedure was considered satisfactory with a majority of minor side effects.

Observation: We describe the 5 year endothelial cell loss after Preserflo implantation in 2 primary open angle glaucoma patients. The case 1 presented a device-cornea touch after a backward migration of the device. The case 2 presented a modified aspect of the device compatible with an inflammatory reaction. Both cases were explanted.

Conclusion: As described in Ahmed glaucoma valve, Xen gel stent and Cypass, Preserflo MicroShunt can lead to endothelial cell loss in some cases. A long-term prospective study with pre and postoperative endothelial cell count and AS-OCT or UBM evaluation of the device positioning would be of great interest to assess the real impact of Preserflo MicroShunt and risk factors for endothelial cell loss.

Keywords: Endothelial cell loss; MIGS; Microshunt; Preserflo; Safety.

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Conflict of interest statement

The following authors have no financial disclosures: CC, SH, EB, YL.

Figures

Fig. 1
Fig. 1
Endothelial cell count with specular microscopy after Preserflo implantation. Fig. 1.I. Patient 1, pseudophakic. A/Right eye = fellow eye; B/Left eye = eye implanted with Preserflo microshunt, the endothelial cell loss affects mostly superior, nasal and temporal quadrants. Fig. 1.II. Patient 2, phakic. A/Right eye = fellow eye; B/Left eye = eye implanted with Preserflo microshunt, the endothelial cell loss concerns superior and nasal quadrants while inferior and temporal are subnormal.
Fig. 2
Fig. 2
Biomicroscopy and AS-OCT trajectory of the Preserflo MicroShunt.Fig. 2.I. Patient 1. a. Biomicroscopy of the left eye, the microshunt is located superiorly, no corneal edema. b. AS-OCT visualizing a horizontal and corneal trajectory of the microshunt. The intracameral portion of the microshunt is very short. Fig. 2.II. Patient 2. a. Biomicroscopy of the left eye, the microshunt is located nasal-superiorly, no corneal edema. b. AS-OCT visualizing a satisfactory trajectory of the microshunt in the cornea and a suficient portion of the shunt in the anterior chamber, far from the cornea and the iris. We must note a hyperreflective structure between the shunt and the endothelium that can be an inflammatory reaction. We can also see a swollen intracameral part of the shunt (*).
See this image and copyright information in PMC

References

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