PRESERFLO MicroShunt implantation is a relatively new and increasingly popular treatment for recalcitrant glaucoma. Though relatively uncommon, persistent or severe postoperative hypotony may occur and its treatment presents a significant challenge.

Interventional case series of the first 7 consecutive patients who underwent the insertion of a rip-cord suture to treat severe or persistent postoperative hypotony.

In 6 patients, the hypotony resolved and vision was restored. The 7th patient had suffered a severe suprachoroidal haemorrhage with a poor visual recovery and limited follow-up, so success was more difficult to assess.

Stenting the PRESERFLO MicroShunt with a rip-cord suture is a simple technique to correct persistent or severe postoperative hypotony.