Blood Reflux Through a PreserFlo MicroShunt Device After Needling

Abstract

Introduction: To report a case of hyphema after a bleb needling revision in a PreserFlo MicroShunt implantation. Case Description: An 87-year-old man suffering from bilateral open angle glaucoma was referred to our hospital with a diagnosis of unsatisfactory intraocular pressure (IOP) control in the right eye, despite the maximally tolerated medical therapy. The patient underwent PreserFlo MicroShunt implantation in his right eye. About 2 months after the surgical procedure, the IOP was raised because of bleb failure for subconjunctival scarring. A needling revision was performed at the slit lamp. During the procedure blood reflux through a PreserFlo MicroShunt device from a filtering bleb to the anterior chamber was observed, causing an IOP rise. Treatment with oral acetazolamide, topical steroid, and antibiotic resulted in the complete resolution of the hyphema in 2 weeks and a significant lowering in IOP. Conclusions: This is the first reported case of blood reflux to the anterior chamber through a PreserFlo MicroShunt implant after a needling procedure.

Dislocation of the PreserFlo MicroShunt During a Postsurgical Needling Procedure

“…When the size of the filtering bleb was reduced postsurgically following PFM implantation, it was treated with a needling procedure [5] or bleb revision [6], similar to trabeculectomy. Complications associated with needling procedures have been reported in eyes implanted with PFM, including blood reflux into the AC [7], conjunctival erosion [8], and endophthalmitis [9]. In this report, we present a case of PFM device dislocation complicated by a postsurgical needling procedure.…”