Short-Term Efficacy and Safety of Preserflo MicroShunt Surgery in Glaucoma Eyes with and without High Myopia.

Précis: This study demonstrated that the Preserflo MicroShunt effectively lowered intraocular pressure in eyes with open-angle glaucoma; however, the reduction was less pronounced in highly myopic eyes than in non-highly myopic eyes.

Purpose

To compare surgical outcomes between eyes with high myopia (HM) and non-HM in open-angle glaucoma (OAG) and to identify risk factors for surgical success.

Methods

This retrospective study included 52 eyes (41 patients) with OAG that underwent Preserflo MicroShunt (PMS) implantation and were followed for 6 months. Eyes were categorized by axial length (AL) into non-HM (AL ≤26.5 mm) and HM (AL >26.5 mm) groups. Surgical success was defined as a ≥20% intraocular pressure (IOP) reduction and postoperative IOP ≤18 mmHg (criterion A), ≤15 mmHg (criterion B), or ≤12 mmHg (criterion C) without increased glaucoma medications. Kaplan-Meier analysis compared cumulative success rates, and Cox regression identified risk factors for failure.

Results

Mean AL was 24.01±1.18 mm in non-HM and 30.26±2.30 mm in HM eyes (P <0.001). IOP and medication use significantly decreased in both groups at all time points (all P <0.001). The non-HM group showed significantly lower IOP at 1 day and 1 week postoperatively (P=0.037 and P=0.034), with no differences after 1 month. At 6 months, surgical success was significantly lower in HM eyes for criteria A and C (P=0.009 and P=0.044). AL was the critical risk factor for surgical failure. No significant differences were found in adverse events between groups.

Conclusions

PMS implantation effectively lowered IOP in both groups; however, surgical success was reduced in HM eyes, suggesting decreased short-term surgical stability.