PRESERFLO™ MicroShunt: the new device revolutionising glaucoma surgery

Written by: Professor Kin Sheng Lim
Edited by: Cameron Gibson-Watt

For patients with early to advanced primary open-angle glaucoma, trabeculectomy has been the go-to treatment to help reduce pressures. Recently, the PRESERFLO™ MicroShunt has been drawing attention, offering a safer and less invasive alternative to managing this progressive eye disease. Internationally renowned London ophthalmologist, Mr Kin Sheng Lim, explains more about this exciting development.

What is the PRESERFLO™ MicroShunt device and what does it treat?

The PRESERFLO™ MicroShunt is a ‘minimally’ invasive glaucoma drainage device. It is a small tube about 8mm in length and it is inserted into the eye to drain fluid build-up in glaucoma patients.


Glaucoma is a common disease that causes a build-up of fluid in the eye and resulting in high pressure and damage to the optic nerves. The MicroShunt implant provides an alternative drainage pathway to lower that pressure. The surgery itself is similar to a trabeculectomy but much simpler to perform, and once the implant is inside the eye, it isn’t visible without a microscope.


What advantages does this device offer?

The implant works by lowering the eye pressure from the build-up of fluid and stops any further damage to your eye. Because the MicroShunt tube is small enough to prevent over-drainage, it is thought to be safer than a traditional trabeculectomy. Furthermore, the surgery is less traumatic to the eye and only takes around 20 minutes to perform.


The recovery time from this procedure is generally quicker and the follow-up visit is also less intensive than after a traditional trabeculectomy. The traditional recovery time is typically between 4 to 6 weeks for trabeculectomy while the recovery from a MicroShunt implant is generally around two weeks.


How is it performed?

This procedure can be performed under local or general anaesthetic. The surgery is usually combined with medication called Mitomycin-C to reduce scarring, similar to a trabeculectomy. The tube is implanted under the thin membrane covering the white of your eye and the skin is then closed with a few small stitches. These stitches are permanent and won’t need to be removed later on.


Who is eligible for this treatment?

All patients who are suitable to undergo a traditional trabeculectomy can have this surgery. Glaucoma patients whose condition is progressing will very often need this treatment. It’s generally recommended for all stages of glaucoma but it is usually performed in patients who either don’t have significant cataracts or have had a previous cataract operation.


What are the risks?

MicroShunt surgery can cause serious complications, although these are very rare. Sometimes, a small amount of haemorrhage or bleeding in the eye can happen, or pressure may become too low or high after the implantation. There is a small chance of needing to have a revision after and there is a long-term risk of infection, just like any glaucoma surgery.


How successful is this treatment?

The treatment is as successful as a traditional trabeculectomy but with fewer complications and less intensive post-op visits and management. Recovery is quicker and the eyes typically feel very comfortable afterward.


Mr Kin Sheng Lim is an expert in this new device and performs this procedure at his clinics in London. To make a consultation with him, visit his profile and check his availability.

By Professor Kin Sheng Lim

Professor K. Sheng Lim is an internationally renowned consultant ophthalmologist based in London specialising in glaucoma and cataract surgeries.

After qualifying from University of Leicester, he obtained his doctorate in medicine from University College London, receiving most of his general ophthalmology training at Moorfields Eye Hospital, the Western Eye Hospital, and the Royal Free Hospital. He underwent further glaucoma training at Moorfields Eye Hospital and The Mayo Clinic in Minnesota, USA. Professor Lim is a consultant, the head of ophthalmology research and the director of the KCL Frost Eye Research Department at St Thomas' Hospital.

He is also the professor of glaucoma studies (Ophthalmology) in the Faculty of Life Sciences and Medicine at King's College London, and has been involved in many landmarked studies in the treatment of glaucoma and is currently the principal and chief investigators of many on-going studies. He is at the forefront of his field, with clinical expertise in cutting-edge glaucoma surgeries such as iStent, Hydrus, PreserFlo (MicroSHunt), ECP laser, laser iridotomy, SLT laser, trabeculectomy, Baerveldt tube and more. He also specialises in cataract surgery, and carries out high volumes of cataract surgery each year.

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