RESUMO
In recent years, minimally invasive glaucoma surgery has emerged as a novel approach to lowering intraocular pressure. This technique, which is usually reserved for mild to moderate cases, is less invasive than classic filtration surgery and potentially offers a better safety profile. The XEN Gel Stent is implanted through a minimally invasive, ab interno procedure to create a subconjunctival pathway. Conjunctival tissue disruption is minimal, and flow is restricted to avoid hypotony. Data on the optimal approach to managing complications associated with this procedure are limited due to the relatively recent commercialization of this device. Here, we report a case of a persistent leaking bleb caused by XEN Stent exposure, which was managed by ab interno repositioning of the stent through the anterior chamber and direct suturing of the conjunctival defect.
Assuntos
Câmara Anterior/cirurgia , Túnica Conjuntiva/lesões , Implantes para Drenagem de Glaucoma/efeitos adversos , Glaucoma de Ângulo Aberto/cirurgia , Reoperação , Ruptura/etiologia , Deiscência da Ferida Operatória/etiologia , Túnica Conjuntiva/cirurgia , Feminino , Glaucoma de Ângulo Aberto/fisiopatologia , Humanos , Pressão Intraocular/fisiologia , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Stents , Deiscência da Ferida Operatória/cirurgia , Tonometria OcularAssuntos
Glaucoma de Ângulo Fechado/etiologia , Síndrome de Noonan/complicações , Doença Aguda , Adulto , Alquilantes/administração & dosagem , Feminino , Glaucoma de Ângulo Fechado/diagnóstico , Glaucoma de Ângulo Fechado/cirurgia , Gonioscopia , Humanos , Pressão Intraocular , Iridectomia , Iris/cirurgia , Terapia a Laser , Mitomicina/administração & dosagem , TrabeculectomiaRESUMO
OBJECTIVE: To determine the medium-term outcome of Ahmed implants inserted through a needle tract at 5 mm from limbus that eliminates the need for a donor scleral graft. METHODS: A retrospective case series of 19 patients undergoing Ahmed implant surgery for refractory glaucoma with a mean follow-up of 12 months. Primary outcome measures included control of intraocular pressure after surgery. Secondary outcome measure included the frequency of intraoperative and postoperative complications. RESULTS: Intraocular pressure was maintained between 6 and 21 mmHg throughout the study. There was no postoperative hypotony. There were no complications related to this modified technique. CONCLUSION: Needle tract at 5 mm from limbus maintains implant's ability to control intraocular pressure and eliminates the need for a donor scleral graft or heterologous material.