RESUMEN
Our purpose is to report the intermediate-term results of the Ex-PRESS® implant as the first surgical option in patients with Iridocorneal Endothelial (ICE) Syndrome. We describe two patients diagnosed from ICE syndrome with medically uncontrolled glaucoma and finally treated with an Ex-PRESS® implant, associating a cataract surgery in one of them. Three years after surgery, intraocular pressure remains stable without any additional medical antiglaucomatous treatment, with a well-located implant surrounded by a diffuse filtering bleb and no sight-threatening adverse events have been documented. In addition, no progression of the disease has been registered. This report encourage the Ex-PRESS® implant to be considered the first surgical option in this patients as it allows a permeable ostium in spite of the progressive synechial angle closure typical of the ICE syndrome.
Asunto(s)
Implantes de Drenaje de Glaucoma , Síndrome Endotelial Iridocorneal , Estudios de Seguimiento , Humanos , Síndrome Endotelial Iridocorneal/cirugía , Tonometría Ocular , Resultado del TratamientoRESUMEN
Se plantea como objetivo dar a conocer los resultados a mediano plazo del implante Ex-PRESS® como primera opción quirúrgica en pacientes con síndrome iridocorneo-endotelial (ICE). Se incluye la descripción de dos mujeres con diagnóstico de síndrome ICE y glaucoma no controlado por medicación, tratadas con el implante Ex-PRESS® y con cirugía de catarata asociada en una de ellas. La presión intraocular se mantiene estable tres años después de la intervención sin necesidad de tratamiento médico adicional anti-glaucoma, con un implante bien colocado y rodeado por una ampolla de filtración difusa, sin eventos adversos documentados que pudieran suponer una amenaza para la vista, y sin un progreso registrado en el curso de la patología. El presente informe propone considerar los implantes Ex-PRESS® como primera opción quirúrgica, al posibilitar la existencia de un ostium permeable, a pesar del cierre progresivo del ángulo sinequial típico del síndrome ICE (AU)
Our purpose is to report the intermediate-term results of the Ex-PRESS® implant as the first surgical option in patients with Iridocorneal Endothelial (ICE) Syndrome. We describe two patients diagnosed from ICE syndrome with medically uncontrolled glaucoma and finally treated with an Ex-PRESS® implant, associating a cataract surgery in one of them. Three years after surgery, intraocular pressure remains stable without any additional medical antiglaucomatous treatment, with a well-located implant surrounded by a diffuse filtering bleb and no sight-threatening adverse events have been documented. In addition, no progression of the disease has been registered. This report encourage the Ex-PRESS® implant to be considered the first surgical option in this patients as it allows a permeable ostium in spite of the progressive synechial angle closure typical of the ICE syndrome (AU)
Asunto(s)
Humanos , Femenino , Adulto , Síndrome Endotelial Iridocorneal/cirugía , Implantes de Drenaje de Glaucoma , Estudios de Seguimiento , Resultado del Tratamiento , Tonometría OcularRESUMEN
SURGICAL TECHNIQUE: The bubble mirror technique consists of the stabilization of the anterior chamber by means of a plug made with a combination of conveniently placed air and viscoelastic material. A line arises at interface between the air and viscoelastic where the anterior chamber angle reflected can be seen as in a mirror (bubble mirror). DISCUSSION: The viscoelastic-air plug offers three advantages in glaucoma surgery with the Ex-PRESS implant: 1) plug effect of viscoelastic, giving stability to the anterior chamber and preventing it from collapsing; 2) toning effect of the air bubble; and 3) specular effect at the interface, which allows the surgeon to visually control the chamber angle during the Ex-PRESS implantation.
