The STARflo™ glaucoma implant: a single-centre experience at 24 months

  • Sofia FiliEmail author
  • Lama Janoud
  • Iraklis Vastardis
  • Peter Wölfelschneider
  • Markus Kohlhaas



To evaluate the 24-month outcomes following STARflo™ implantation in patients with moderate or advanced open-angle glaucoma.


We enrolled 32 patients (40 eyes) with high intraocular pressure (IOP) resistant to topical and systemic medical therapy. After baseline assessments, patients were implanted with STARflo™ implants with the goal of IOP reduction and long-term maintenance. Patients were followed for 24 months. Complete success of implantation was defined as a restoration of normal IOP without topical glaucoma medications, while qualified success was defined as a restoration of normal IOP with implantation and topical glaucoma medications.


STARflo™ did not satisfactorily reduce IOP at 24 months. Twenty-eight eyes (70%) had elevated IOP at least once during the 24 months post-implantation period. Five eyes (12.5%) developed corneal decompensation. The average IOP 24 months after the surgery was 13.42 ± 6.03 mmHg and was not significantly different than IOP at 12 months (13.2 ± 5.59 mmHg). Moreover, 45% of treated eyes needed additional glaucoma procedures after 1 year and 2 years to achieve these IOPs. STARflo™ did reduce the average number of topical glaucoma medications from 2.7 pre-implantation to 1.17 at 24 months postoperatively in the rest 55% of the eyes.


The STARflo™ implantation did not meet success criteria and so appears to be an ineffective alternative to filtering surgical procedures for patients with treatment-refractory open-angle glaucoma.


STARflo™ implant Intraocular pressure Glaucoma Loss of corneal endothelial cells Corneal decompensation 



argon laser trabeculoplasty


blebless ab-externo glaucoma surgery


cup-to-disc ratio


Descemet membrane endothelial keratoplasty


corneal endothelial cell density


mean deviation


micro-invasive glaucoma surgery


posterior chamber intraocular lenses




primary open-angle glaucoma


pattern standard deviation


selective laser trabeculoplasty


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee of St. Johannes Hospital in Dortmund, Germany, and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was freely given and obtained from all participants in this study.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of OphthalmologySt. Johannes HospitalDortmundGermany

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