Prcis: This systematic review and meta-analysis concludes that the PreserFlo Microshunt glaucoma drainage device significantly reduces intraocular pressure in primary open angle glaucoma patients at 12 months postinsertion., Purpose: A systematic review and meta-analysis on the effect of the PRESERFLO MicroShunt (PF-MS) on intraocular pressure (IOP) at 12 months has been conducted., Method: The PubMed/MEDLINE, Embase, CENTRAL, Google Scholar, Scopus, and Web of Science databases were searched. Inclusion criteria required a diagnosis of open angle glaucoma, PF-MS insertion, and examination of IOP over time. Meta-analyses were conducted on the primary outcome of IOP and the secondary outcome of glaucoma medication regime. Adverse events were also noted., Results: Fourteen studies were identified for inclusion in the meta-analyses, of which none had a high risk of bias. The meta-analyses found a significant mean reduction in IOP of 9.07 mm Hg (95% CI: 7.88-10.25; P <0.0001) and a significant mean reduction in mean glaucoma medication requirement of 2.37 medications (95% CI: 2.15-2.60; P <0.0001). Hypotony and hyphaema are common early complications., Conclusions: The PF-MS device significantly reduced both IOP and glaucoma medication requirement at 12 months postinsertion in individuals with open angle glaucoma without a significant adverse event burden. Further research is required to determine the economic and environmental effects of widely implementing the PF-MS device into clinical practice., Competing Interests: Disclosure: The authors declare no conflict of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)