# Salvaging a Failed PreserFlo MicroShunt Using a Telescopic Tube‐in‐Tube Connection Technique With an EyePlate Implant: A Case Report

## TL;DR

A new surgical technique connects a failed glaucoma device to a new implant, preserving the original tunnel and reducing complications.

## Contribution

A novel telescopic tube-to-tube connection technique is introduced to salvage a failed PreserFlo MicroShunt.

## Key findings

- Postoperative IOP decreased from 40 to 10 mmHg and remained stable for 6 months.
- The technique preserved the original scleral tunnel and avoided full device explantation.
- This approach may serve as a minimally invasive alternative to conventional revision surgery.

## Abstract

The PreserFlo MicroShunt is a subconjunctival glaucoma drainage device designed to reduce intraocular pressure (IOP) via a minimally invasive approach. However, device failure due to bleb fibrosis remains a significant clinical challenge, especially when initial revision surgery is unsuccessful. We present a 75‐year‐old male with pseudoexfoliation glaucoma who previously underwent PreserFlo MicroShunt implantation and a subsequent revision procedure at an outside institution. Due to persistently elevated IOP and progressive visual decline, he was referred to our center for further management. A novel telescopic tube‐to‐tube connection was performed between the existing PreserFlo MicroShunt and a new EyePlate‐200 implant, utilizing and preserving the original scleral tunnel. Postoperative IOP decreased from 40 to 10 mmHg and remained stable without complications during a 6‐month follow‐up. A surgical video is provided as Video 1. This case illustrates a novel telescopic tube‐to‐tube connection technique to restore aqueous outflow in cases of PreserFlo MicroShunt failure. By preserving the original scleral tunnel, this approach may offer a minimally invasive alternative to complete device explantation or conventional tube shunt surgery.

A telescopic tube‐in‐tube connection between a failed PreserFlo MicroShunt and an EyePlate‐200 implant may offer a minimally invasive rescue technique that preserves the original scleral tunnel and avoids full device explantation.