The PreserFlo MicroShunt is a small drainage device used in the surgical management of glaucoma, an eye condition in which raised pressure inside the eye can gradually damage the optic nerve.
What Is the PreserFlo MicroShunt?
The PreserFlo MicroShunt is a very fine tube, roughly 8.5mm long with an extremely narrow internal channel, made from a flexible, biocompatible synthetic material designed to be well tolerated by the eye. It is implanted surgically to create a new, controlled drainage pathway for the fluid (aqueous humour) that the eye continuously produces. Fluid passes from the front chamber of the eye through the shunt and collects under the conjunctiva, the thin membrane covering the white of the eye, forming a small reservoir known as a bleb. From there the fluid is absorbed naturally.
By improving outflow, the aim is to lower the pressure inside the eye. Lowering intraocular pressure remains the only proven way to slow the progression of glaucoma, as described by the NHS and in guidance published by NICE. The device is implanted through a small incision from the outside of the eye, which means the drainage channel can be created without extensive dissection inside the eye itself.
Who May Benefit From This Treatment?
PreserFlo MicroShunt surgery may be considered for adults with open-angle glaucoma where the eye pressure remains higher than the target level despite maximum tolerated medical therapy, or where glaucoma is continuing to progress on monitoring. It may also be discussed with patients who struggle with eye drops, for example because of allergy, surface irritation, difficulty instilling drops, or difficulty maintaining a daily routine.
You may be advised to seek a specialist glaucoma assessment if you experience:
- eye pressure readings that remain above your individual target despite treatment
- visual field loss that appears to be worsening on repeated testing
- thinning of the optic nerve fibre layer on OCT scans over time
- persistent irritation, redness or discomfort from long-term glaucoma drops
- difficulty using drops reliably because of arthritis, tremor or memory problems
- advanced glaucoma at diagnosis, where more rapid pressure control may be needed
Not everyone with glaucoma needs surgery, and the procedure is not suitable for all eye types. Certain forms of glaucoma, previous conjunctival scarring, some corneal conditions and particular anatomical features may make an alternative approach more appropriate. Your clinician will advise you based on your full assessment.
Conditions and Problems This Procedure May Address
- primary open-angle glaucoma that is inadequately controlled
- pseudoexfoliative and pigmentary glaucoma, in selected cases
- ocular hypertension with high risk of progression, in specific circumstances
- glaucoma progressing despite drops, laser trabeculoplasty or previous surgery
- intolerance or poor adherence to topical glaucoma medication
- the need to reduce the burden of multiple daily eye drops
Potential Benefits
Outcomes vary between individuals, and no glaucoma operation can restore vision that has already been lost. Where surgery is successful, potential benefits may include:
- a meaningful and sustained reduction in intraocular pressure
- a reduced need for glaucoma eye drops, and in some cases no drops at all
- improved comfort of the ocular surface once drops are reduced
- support for long-term stability of the optic nerve and visual field
- a lower likelihood of further deterioration when pressure targets are achieved
- a simpler daily routine for patients who find drops difficult
The purpose of treatment is protective: it aims to preserve the sight you currently have rather than to improve vision.
Consultation and Assessment
Careful assessment is essential before any glaucoma surgery is planned. During your consultation with Ms Diana Urbaneja you can expect:
- a detailed discussion of your symptoms, medical history, medications and any previous eye treatment
- measurement of visual acuity and intraocular pressure
- slit lamp examination of the front of the eye and gonioscopy to assess the drainage angle
- examination of the optic nerve, often with dilating drops
- visual field testing and OCT imaging to document the stage of glaucoma
- corneal thickness measurement where relevant
- an explanation of the realistic aims of surgery, alternatives, and the risks involved
Alternatives such as additional or different eye drops, selective laser trabeculoplasty, MIGS procedures, combined cataract and glaucoma surgery, or trabeculectomy will be discussed so that you can give informed consent. Some patients with a visually significant cataract may be advised to consider combined surgery, including cataract surgery with a premium intraocular lens where appropriate.
How the Procedure Is Performed
PreserFlo MicroShunt surgery is normally carried out as a day case in a hospital or surgical unit, so you can usually go home the same day. Most patients have the operation under local anaesthetic, with the eye numbed by injection or drops and sedation available if needed. General anaesthetic is occasionally used.
In broad terms, the surgeon opens a small area of conjunctiva, applies an anti-scarring agent, creates a fine channel into the front chamber of the eye, inserts the microshunt so that it sits in a shallow pocket, and then closes the tissue over it. The operation commonly takes around 30 to 45 minutes. You will need someone to take you home afterwards, and the eye is usually protected with a shield for the first night.
Recovery and Aftercare
Recovery varies from person to person. Vision is often blurred initially and typically settles gradually over several weeks. You will be given anti-inflammatory and antibiotic drops to use for a period after surgery, and your usual glaucoma drops in that eye are normally stopped.
Follow-up is frequent in the early stages, often the day after surgery, then at intervals over the following weeks and months, so that pressure and healing can be monitored closely. Some eyes need additional in-clinic measures such as needling or adjustment of medication to encourage the drainage pathway to work well.
General guidance usually includes avoiding rubbing the eye, avoiding swimming and dusty environments for a period, and limiting heavy lifting and strenuous exercise in the early weeks. Many people return to light activities within a week or two, though driving depends on your vision meeting legal standards. Contact your surgeon or an eye casualty department promptly if you develop increasing pain, marked redness, sudden loss of vision or discharge.
01
Consultation
Suitability assessment
02
Surgery
MicroShunt implantation, day case
03
Aftercare
Monitoring & drops
Considering PreserFlo MicroShunt surgery?
Guide Price
Price TBC
Priced according to your individual case. See the pricing page for all options.
At a glance
Anaesthetic
Local
Procedure time
~20-30 min
Stay
Day case
Recovery
A few weeks
Follow-up
Regular monitoring