Preserflo MicroShunt Implantation for Glaucoma Secondary to Viral and Juvenile Idiopathic Arthritis-Related Anterior Uveitis

Abstract

Purpose: To investigate the efficacy and safety of the Preserflo MicroShunt (PMS) in treating glaucoma secondary to different uveitic glaucoma (UG) types in a European population.

Methods: This study evaluated consecutive eyes with UG that received the PMS. The primary outcome measure was 12-month surgical success (≥20% IOP reduction, target IOP of 6-21 mmHg). Complete success was considered without IOP-lowering medication or additional surgery other than needling. Qualified success A was considered regardless of medication use, and qualified success B regardless of medication and/or incisional bleb revision. The secondary outcome measures included revision and complication rates.

Results: Twenty-five eyes (viral group: 10 with Fuchs uveitis syndrome and six with herpetic uveitis; juvenile idiopathic arthritis (JIA) group: nine with JIA-related uveitis) were included. The 12-month complete success rate was significantly higher in the viral group than in the JIA group (69% vs 11%; p = 0.0059, log-rank test). The qualified success rates in the viral and JIA groups were 75% and 22% for category A (p = 0.029) and 94% and 56% for category B (p = 0.0237), respectively. Among the viral and JIA groups, 13% and 11% required medication, respectively. Incisional bleb revisions were conducted within 12 months in 25% and 78%, respectively (p = 0.0131, log-rank test). Complications were self-limiting, with no uveitic activity observed.

Conclusion: The PMS is safe and effective for glaucoma secondary to viral anterior uveitis. Conversely, it is moderately effective in eyes with JIA-related UG, with a high probability of bleb fibrosis development.

Keywords: Fuchs uveitis syndrome; herpetic uveitis; juvenile idiopathic-arthritis; preserflo microshunt; uveitic glaucoma.