Jpn J Ophthalmol. 2026 Jan 14. doi: 10.1007/s10384-025-01325-w. Online ahead of print.
ABSTRACT
PURPOSE: To investigate the incidence and clinical characteristics of malignant glaucoma (MG) following Preserflo MicroShunt (PMS) implantation.
STUDY DESIGN: Retrospective multicenter cohort study METHODS: We investigated 957 consecutive eyes that underwent PMS implantation between August 2022 and May 2025. In all eyes, patient age, sex, glaucoma subtype, preoperative intraocular pressure (IOP), medication score, axial length (AL), and use of intraluminal suture stenting (ISS) were examined. We identified cases in which MG developed postoperatively and compared age, preoperative IOP, medication score, and AL between the MG and non-MG groups. The timing of MG onset and treatment outcomes were also evaluated. After Bonferroni correction, the adjusted significance level was set at P<0.0125 (0.05/4).
RESULTS: MG occurred in 4 eyes (0.42%) of 2 men and 2 women, with a median age of 85.5 years (interquartile range [IQR], 84-90 years). All eyes were diagnosed with exfoliation glaucoma (XFG). Patients in whom MG developed were significantly older (P=0.006) and had a significantly higher preoperative IOP (P=0.006) than those without MG. No significant differences in AL or medication score were observed between the groups. MG developed on postoperative days 2, 3, and 4 in 3 eyes without ISS. In 1 case with ISS, MG occurred 3 days after ISS removal, but not during ISS placement. All MG cases were successfully treated with irido-zonulo-hyaloido-vitrectomy, with or without pars plana vitrectomy.
CONCLUSIONS: Although rare, MG can occur in the early postoperative period after PMS implantation, particularly in older patients with a high preoperative IOP.
PMID:41533256 | DOI:10.1007/s10384-025-01325-w
