Scleral bridging technique for preventing PreserFlo microshunt exposure: A case report

Abstract

Introduction: The use of the PreserFlo microshunt is gaining popularity owing to its ease of implantation and reduced need for postoperative intervention compared to conventional trabeculectomy. Patient concerns: However, microshunt exposure remains a severe complication of PreserFlo surgery, particularly in patients with a thin Tenon capsule and conjunctiva. However, the actual thickness and intensity of the Tenon capsule or conjunctiva can be confirmed only during surgery. Diagnosis: Exfoliation glaucoma with previous several glaucoma surgeries with thinner Tenon capsule or conjunctiva. Interventions: We performed PreserFlo implantation with a surgical technique to recover a thin Tenon capsule and conjunctiva by creating a half-thickness rectangular scleral flap under the shunt and covering it over the microshunt until the distal part, similar to the bridge. Outcomes: The patient had better intraocular pressure control with positive cosmetic appearance using this technique. Conclusion: This technique will be beneficial for both preventing exposure and holding down the top, in addition to improving cosmetic appearance.