Conjunctival Advancement Procedure for Repairing Conjunctival Exposure of the PreserFlo MicroShunt

Abstract

A 59-year-old Japanese woman with primary open-angle glaucoma underwent PreserFlo MicroShunt (PFM) (Santen Pharmaceutical Co., Ltd., Osaka, Japan) implantation in her left eye. Six weeks postoperatively, a conjunctival exposure of the posterior end of the device was observed, accompanied by aqueous leakage. The patient had no identifiable risk factors for exposure, such as previous conjunctival incisional surgeries, significant blepharitis, or needling procedures. Conjunctival advancement surgery was performed to cover the exposed device. After the sufficient dissection of scar tissue surrounding the PFM and the reapproximation of the conjunctiva, the device was successfully covered. Postoperatively, the filtration bleb remained formed, and the intraocular pressure (IOP) was controlled. No recurrence of device exposure was observed after 18 months of follow-up. Although PFM device exposure is a rare complication, it requires prompt surgical intervention to prevent infection and maintain IOP control. Conjunctival advancement surgery is an effective treatment option that allows for the repair of the exposure while preserving the filtration function of the device.