{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T18:04:53Z","timestamp":1786125893763,"version":"build-2736575974"},"reference-count":10,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Br J Ophthalmol"],"accepted":{"date-parts":[[2026,7,27]]},"abstract":"<jats:p>We report a novel surgical approach for managing late hypotony in PreserFlo MicroShunt blebs. Hypotony is a well-known complication of glaucoma filtering surgery, yet treatment options for late-onset cases remain limited. We describe two cases of uveitic glaucoma presenting with hypotony several months after PreserFlo implantation. Both patients were successfully treated with a bleb-modifying procedure. Under local anaesthesia, several interrupted 10-0\u2009nylon sutures were placed in the bleb region to reduce its size and sectorise it, creating an iatrogenic \u2018ring of steel\u2019 that effectively corrected overfiltration. This technique appears to be a feasible and potentially effective option for managing late hypotony.<\/jats:p>","DOI":"10.1136\/bjo-2025-328345","type":"journal-article","created":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:20:18Z","timestamp":1786123218000},"page":"bjo-2025-328345","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Novel surgical approach to correct late-hypotony in PreserFlo MicroShunt"],"prefix":"10.1136","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-2074-9760","authenticated-orcid":false,"given":"Bruno","family":"Guerreiro Dias","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Hospital de Santa Maria\u2014Unidade Local de Sa\u00fade de Santa Maria, Lisbon, Portugal"},{"name":"Cl\u00ednica Universit\u00e1ria de Oftalmologia, Unidade Local de Sa\u00fade de Santa Maria, Lisbon, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafael","family":"Whitfield","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Hospital de Santa Maria\u2014Unidade Local de Sa\u00fade de Santa Maria, Lisbon, Portugal"},{"name":"Cl\u00ednica Universit\u00e1ria de Oftalmologia, Unidade Local de Sa\u00fade de Santa Maria, Lisbon, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"In\u00eas","family":"Leal","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Hospital de Santa Maria\u2014Unidade Local de Sa\u00fade de Santa Maria, Lisbon, Portugal"},{"name":"Cl\u00ednica Universit\u00e1ria de Oftalmologia, Unidade Local de Sa\u00fade de Santa Maria, Lisbon, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lu\u00eds","family":"Abeg\u00e3o Pinto","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Hospital de Santa Maria\u2014Unidade Local de Sa\u00fade de Santa Maria, Lisbon, Portugal"},{"name":"Cl\u00ednica Universit\u00e1ria de Oftalmologia, Unidade Local de Sa\u00fade de Santa Maria, Lisbon, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,8,7]]},"reference":[{"key":"2026080710200976000_bjo-2025-328345v1.1","first-page":"389","article-title":"Hypotony maculopathy following the use of topical mitomycin C in glaucoma filtration surgery","volume":"24","author":"Costa","year":"1993","journal-title":"Ophthalmic Surg"},{"key":"2026080710200976000_bjo-2025-328345v1.2","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1016\/S0161-6420(97)30332-7","article-title":"Hypotony maculopathy after filtering surgery with mitomycin C. 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