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

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.