{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T19:55:54Z","timestamp":1789588554562,"version":"build-2803163510"},"reference-count":22,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2025,9,3]],"date-time":"2025-09-03T00:00:00Z","timestamp":1756857600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Munich Medical &amp; Clinician Scientist Program, LMU Munich","award":["CS051"],"award-info":[{"award-number":["CS051"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Early postoperative hypotony and complications like choroidal detachment can occur after Preserflo MicroShunt (MS) implantation in patients with pseudoexfoliation glaucoma (PEXG). To prevent these risks, outflow from the microshunt tube can be reduced by implementing a nylon stent. This study aims to evaluate the impact of intraluminal stenting of the MS during the first four months after surgery. Methods: This retrospective study of 43 eyes investigated the incidence of intraocular hypotony in PEXG patients undergoing MS implantation with (n = 23) or without (n = 20) intraluminal stenting using a 10.0 nylon suture. The follow-up period was four months after surgery. Results: Our results demonstrated that intraluminal stenting significantly reduced the incidence of postoperative complications related to hypotony. Notably, no cases of choroidal detachment occurred in the nylon-stenting group (nsMS) compared to 30% (6 eyes) in the MS-only group (p = 0.0064). The hypotony rates between the nsMS (21.74%, 5 eyes) and the MS-only group (40%, 8 eyes) did not significantly differ (p = 0.3184). Both groups experienced significant reductions in intraocular pressure (p &lt; 0.001) and a decrease in the number of antiglaucomatous medications (p &lt; 0.001) up to four months after surgery. Conclusions: The use of an intraluminal stent (10.0 nylon suture) during MS implantation may be a promising strategy to reduce the risk of hypotony-related complications, particularly choroidal detachment, in patients with PEXG.<\/jats:p>","DOI":"10.3390\/jcm14176224","type":"journal-article","created":{"date-parts":[[2025,9,3]],"date-time":"2025-09-03T15:15:57Z","timestamp":1756912557000},"page":"6224","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Intraluminal 10-0 Nylon Stenting in PRESERFLO\u2122 MicroShunt Surgery for Pseudoexfoliation Glaucoma"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-0664-2402","authenticated-orcid":false,"given":"Miranda","family":"Gehrke","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, LMU University Hospital, LMU Munich, Mathildenstr. 8, 80336 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4144-5754","authenticated-orcid":false,"given":"Leonie F.","family":"Keidel","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, LMU University Hospital, LMU Munich, Mathildenstr. 8, 80336 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lara","family":"Buhl","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, LMU University Hospital, LMU Munich, Mathildenstr. 8, 80336 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5580-612X","authenticated-orcid":false,"given":"Siegfried G.","family":"Priglinger","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, LMU University Hospital, LMU Munich, Mathildenstr. 8, 80336 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4473-2812","authenticated-orcid":false,"given":"Marc J.","family":"Mackert","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, LMU University Hospital, LMU Munich, Mathildenstr. 8, 80336 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Saeed, E., Golaszewska, K., Dmuchowska, D.A., Zalewska, R., and Konopinska, J. (2023). The PreserFlo MicroShunt in the Context of Minimally Invasive Glaucoma Surgery: A Narrative Review. Int. J. Environ. Res. Public Health, 20.","DOI":"10.3390\/ijerph20042904"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Scheres, L.M.J., van den Biggelaar, F., Winkens, B., Kujovic-Aleksov, S., Muskens, R., de Waard, P.W.T., de Crom, R.M.P.C., Ernest, P.J.G., Pijl, B.J., and Ramdas, W.D. (2023). Effectiveness and cost-effectiveness of MicroShunt implantation versus standard trabeculectomy for open-angle glaucoma (a SIGHT study): Study protocol of a multicentre randomised controlled trial. BMC Ophthalmol., 23.","DOI":"10.1186\/s12886-022-02734-y"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Nobl, M., Grun, C., Kassumeh, S., Priglinger, S., and Mackert, M.J. (2023). One-Year Outcomes of Preserflo(TM) MicroShunt Implantation versus Trabeculectomy for Pseudoexfoliation Glaucoma. J. Clin. Med., 12.","DOI":"10.3390\/jcm12083000"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Storp, J.J., Vietmeier, F.E., Mert\u00e9, R.L., Koch, R., Zimmermann, J.A., Eter, N., and Br\u00fccher, V.C. (2023). Long-Term Outcomes of the PRESERFLO MicroShunt Implant in a Heterogeneous Glaucoma Cohort. J. Clin. Med., 12.","DOI":"10.3390\/jcm12134474"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"370371","DOI":"10.1155\/2015\/370371","article-title":"Pseudoexfoliation Syndrome and Pseudoexfoliation Glaucoma: A Review of the Literature with Updates on Surgical Management","volume":"2015","author":"Plateroti","year":"2015","journal-title":"J. Ophthalmol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"247","DOI":"10.4274\/tjo.galenos.2023.76300","article-title":"Pseudoexfoliation Glaucoma: Clinical Presentation and Therapeutic Options","volume":"53","author":"Yuksel","year":"2023","journal-title":"Turk. J. Ophthalmol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1139","DOI":"10.1055\/a-0972-4548","article-title":"Pseudoexfoliation Syndrome and Glaucoma","volume":"236","author":"Nobl","year":"2019","journal-title":"Klin. Monbl. Augenheilkd."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Nobl, M., Freissinger, S., Kassumeh, S., Priglinger, S., and Mackert, M.J. (2021). One-year outcomes of microshunt implantation in pseudoexfoliation glaucoma. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0256670"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2126","DOI":"10.1038\/s41433-022-02301-1","article-title":"A simple surgical solution for the treatment of persistent postoperative hypotony after PRESERFLO MicroShunt implantation","volume":"37","author":"Tham","year":"2023","journal-title":"Eye"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"3925","DOI":"10.1007\/s00417-024-06567-x","article-title":"The use of intraluminal PRESERFLO stenting in avoiding early postoperative hypotony","volume":"262","author":"Dakroub","year":"2024","journal-title":"Graefes Arch. Clin. Exp. Ophthalmol."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Miura, Y., Fukuda, K., and Yamashiro, K. (2025). Comparison of outcomes with and without intrastent placement during PMS surgery. Sci. Rep., 15.","DOI":"10.1038\/s41598-025-87259-2"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Lupardi, E., Laffi, G.L., Moramarco, A., Barboni, P., and Fontana, L. (2023). Systematic Preserflo MicroShunt Intraluminal Stenting for Hypotony Prevention in Highly Myopic Patients: A Comparative Study. J. Clin. Med., 12.","DOI":"10.3390\/jcm12041677"},{"key":"ref_13","unstructured":"Shaarawy, T., Grehn, F., Sherwood, M., and World Glaucoma, A. (2009). WGA Guidelines on Design and Reporting of Glaucoma Surgical Trials, Kugler Publications. [1st ed.]."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2643","DOI":"10.1007\/s10792-023-02664-8","article-title":"Intraoperative primary partial occlusion of the PreserFlo MicroShunt to prevent initial postoperative hypotony","volume":"43","author":"Luke","year":"2023","journal-title":"Int. Ophthalmol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1016\/j.ophtha.2014.08.043","article-title":"Five-year treatment outcomes in the Ahmed Baerveldt comparison study","volume":"122","author":"Budenz","year":"2015","journal-title":"Ophthalmology"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Pereira, I.C.F., Wyss, H.M., Pinchuk, L., Beckers, H.J.M., and den Toonder, J.M.J. (2022). A model for designing intraocular pressure-regulating glaucoma implants. PLoS ONE, 17.","DOI":"10.1371\/journal.pone.0273672"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"810","DOI":"10.1111\/j.1600-0420.2007.00903.x","article-title":"Cataract and glaucoma surgery in pseudoexfoliation syndrome: A review","volume":"85","author":"Drolsum","year":"2007","journal-title":"Acta Ophthalmol. Scand."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Borjan, I., Stani\u0107, R., Ple\u0161tina-Borjan, I., Pavi\u0107, M., Hertzberg, S.N.W., Znaor, L., Petrovski, B.\u00c9., and Petrovski, G. (2023). Pseudoexfoliative Syndrome in Cataract Surgery-A Quality Register Study and Health Economic Analysis in the Split-Dalmatia County, Croatia. J. Clin. Med., 13.","DOI":"10.3390\/jcm13010038"},{"key":"ref_19","unstructured":"Tuteja, S., Zeppieri, M., and Chawla, H. (2025). Pseudoexfoliation Syndrome and Glaucoma. StatPearls, StatPearls Publishing LLC. StatPearls Publishing Copyright \u00a9 2025."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"805","DOI":"10.1055\/a-2152-8455","article-title":"Long-term Outcomes of PreserFlo MicroShunt versus XEN45 Gel Stent in Open-Angle Glaucoma","volume":"241","author":"Nobl","year":"2024","journal-title":"Klin. Monbl Augenheilkd."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"644","DOI":"10.1038\/s41433-022-01995-7","article-title":"Short-term safety and efficacy of Preserflo Microshunt in glaucoma patients: A multicentre retrospective cohort study","volume":"37","author":"Bhayani","year":"2023","journal-title":"Eye"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1007\/s00347-024-02052-2","article-title":"Occlusion of the PreserFlo(R) MicroShunt implant by iris tissue","volume":"121","author":"Weber","year":"2024","journal-title":"Ophthalmologie"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/17\/6224\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:38:52Z","timestamp":1760035132000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/17\/6224"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,3]]},"references-count":22,"journal-issue":{"issue":"17","published-online":{"date-parts":[[2025,9]]}},"alternative-id":["jcm14176224"],"URL":"https:\/\/doi.org\/10.3390\/jcm14176224","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,3]]}}}