ArticleEye (London, England)2026
Standalone versus combined preserflo MicroShunt surgery: A two-year controlled cohort study.
Article in Eye (London, England), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesTo compare efficacy, safety, and surgical success of standalone Preserflo MicroShunt (PMS) implantation versus PMS combined with phacoemulsification in open-angle glaucoma (OAG).
methodsA retrospective cohort study included consecutive OAG patients who underwent standalone or combined PMS surgery with 0.04% mitomycin C at a tertiary centre. Primary outcomes were intraocular pressure (IOP), glaucoma medications, and surgical success at 2 years. Success was defined as ≥20% IOP reduction with IOP <18 mmHg (criterion 1) or ≥30% reduction with IOP <18 mmHg (criterion 2).
resultsA total of 173 eyes (113 standalone, 60 combined) were analysed. Mean IOP decreased from 22.1 ± 5.8 mmHg to 12.5 ± 3.1 mmHg ( - 39.4%) in the standalone group and from 20.6 ± 6.7 mmHg to 14.2 ± 4.0 mmHg ( - 33.0%) in the combined group (p = 0.023; 95% CI -3.16 to -0.25), with similar medication use in both groups. Success rates were 76.1% versus 61.7% for criterion 1 (p = 0.084) and 70.0% versus 41.7% for criterion 2 (p = 0.001). Kaplan-Meier analysis showed higher cumulative success in standalone surgery (criterion 1: HR 1.77, p = 0.044; criterion 2: HR 2.40, p = 0.0003). Complications occurred in 38.2% of eyes (36.3% standalone, 41.7% combined), with only 6.4% requiring surgical intervention.
conclusionBoth standalone and combined PMS implantation achieved significant IOP and medication reductions with acceptable safety. However, standalone PMS appears to offer superior mid-term IOP control and higher surgical success, supporting its use in advanced glaucoma cases requiring maximal pressure reduction.
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