scholarly journals Iris-Occlusion of XEN Gel Stent following Ab Externo Transconjunctival Implantation Technique

2021 ◽  
Vol 2021 ◽  
pp. 1-3
Author(s):  
Sunil Ruparelia ◽  
Nir Shoham-Hazon
Keyword(s):  
Intraocular Pressure ◽  
Postoperative Complications ◽  
Minimally Invasive ◽  
Stent Implantation ◽  
Rare Case ◽  
Surgical Techniques ◽  
Glaucoma Surgery ◽  
Implantation Technique ◽  
Xen Gel Stent ◽  
Elevated Intraocular Pressure

The use of minimally invasive glaucoma surgery (MIGS) devices has become increasingly common for the management of elevated intraocular pressure (IOP) in the context of glaucoma. These technologies have traditionally been associated with fewer postoperative complications than conventional surgical techniques. However, we report on a rare case of transient XEN occlusion associated with pupil dilation following XEN gel stent implantation. This case highlights that in future XEN implantations, it may be preferable to position the XEN at a lesser angle to the iris to prevent such an occlusion. The use of different positionings of XEN is performed to optimize outcomes. However, it is highlighted that complications may arise in certain circumstances.

scholarly journals Recommendations for the management of elevated intraocular pressure due to bleb fibrosis after XEN gel stent implantation

2019 ◽  
Vol Volume 13 ◽  
pp. 685-694 ◽  
Author(s):  
Vanessa Vera ◽  
Arsham Sheybani ◽  
Dan Lindfield ◽  
Ingeborg Stalmans ◽  
Iqbal Ike K Ahmed
Keyword(s):  
Intraocular Pressure ◽  
Stent Implantation ◽  
Xen Gel Stent ◽  
Elevated Intraocular Pressure

Conjunctival bleb tearing by XEN gel stent after conjunctival compression sutures

2020 ◽  
pp. 112067212097086
Author(s):  
Santiago Montolío-Marzo ◽  
Aitor Lanzagorta-Aresti ◽  
Jose Vicente Piá-Ludeña ◽  
Juan María Davó-Cabrera
Keyword(s):  
Adverse Effects ◽  
Minimally Invasive ◽  
Stent Implantation ◽  
Glaucoma Surgery ◽  
Minimally Invasive Glaucoma Surgery ◽  
Xen Gel Stent ◽  
Good Outcome ◽  
Ab Interno ◽  
Conjunctival Bleb

Purpose: As minimally invasive glaucoma surgery devices emerge, newer complications are reported. XEN gel stent is safer than classic glaucoma surgery but may also lead to severe adverse effects as hypotony. Compression conjunctival sutures are a useful treatment for overfiltration hypotony after XEN gel stent implantation, but might force bleb tearing by the implant as it gets tightly close to the sutured conjunctiva. This complication has not been previously reported. Methods: We report a patient with overfiltration hypotony after XEN gel implantation. Conjunctival compression sutures and implant relocation ab interno were performed obtaining a good outcome. As conjunctiva got tightly close to the stent, the device eroded the bleb so leakage and implant extrusion were found. Results: Bleb reconstruction by conjunctival autograft was performed in order to avoid hypotony due to continuous conjunctival leakage. Conclusion: Conjunctival compression sutures may be used for overfiltration control after XEN gel implantation but we must be aware of potential conjunctival damage due to implant erosion even if it is correctly positioned. Close follow-up and early suture release may be convenient in these patients.

scholarly journals Triggerfish Recording of IOP Patterns in Combined HFDS Minimally Invasive Glaucoma and Cataract Surgery: A Prospective Study

2021 ◽  
Vol 10 (16) ◽  
pp. 3472
Author(s):  
Bojan Pajic ◽  
Mirko Resan ◽  
Brigitte Pajic-Eggspuehler ◽  
Horace Massa ◽  
Zeljka Cvejic
Keyword(s):  
Circadian Rhythm ◽  
Intraocular Pressure ◽  
Minimally Invasive ◽  
Prospective Study ◽  
Cataract Surgery ◽  
High Frequency ◽  
Glaucoma Surgery ◽  
Before And After ◽  
Contact Lens Sensor ◽  
A Prospective Study

Background: The aim of the study is to investigate whether the circadian IOP rhythm can be influenced by combined cataract surgery with high frequency deep sclerotomy (HFDS) and whether intraocular pressure (IOP) can be significantly reduced by HFDS. Methods: In our study 10 patients were included, in whom 24 h IOP monitoring was installed before and after HFDS/cataract surgery using a Triggerfish. HFDS is a minimally invasive glaucoma surgery (MIGS). Results: After performed HFDS combined with cataract surgery, the IOP was reduced from 27.7 ± 2.11 mmHg to 14.4 ± 2.59 mmHg, which is highly significant (p < 0.001). The contact lens sensor (CLS) cosinor analysis pre- and postoperatively showed that the circadian rhythm is not influenced by the surgery, i.e., the circadian IOP rhythm did not show significant differences before and after surgery. Conclusions: HFDS combined with cataract surgery is a potent surgical method that can significantly reduce the IOP. However, the circadian rhythm cannot be changed by the surgery. The acrophase remained during the night in all patients.

scholarly journals Cataract Surgery Combined with Trabecular MIGS (Minimally Invasive Glaucoma Surgery)

2020 ◽  
Author(s):  
Marina Aguilar González ◽  
Jorge Vila Arteaga ◽  
Jose Marí Cotino
Keyword(s):  
Intraocular Pressure ◽  
Minimally Invasive ◽  
Cataract Surgery ◽  
Excimer Laser ◽  
Aqueous Humor ◽  
Trabecular Meshwork ◽  
Glaucoma Surgery ◽  
Minimally Invasive Glaucoma Surgery ◽  
Advanced Glaucoma ◽  
Physiological Approach

Cataract surgery decreases significantly and with maintained effect intraocular pressure (IOP) in both normal eyes as in eyes with glaucoma. In patients with cataracts and glaucoma, it can be performed, isolated or in combination with other techniques, such as the following: minimally invasive glaucoma surgery (MIGS) in patients with mild/moderate glaucoma that do not require a high tensional decrease; and conventional glaucoma surgery techniques in patients with advanced glaucoma. Although lower than with conventional techniques, MIGS trabecular surgery has a good IOP lowering effect and provides some of the following advantages: a more physiological approach; little traumatic; without bleb; and it does not limit other techniques in the future. Different techniques that combinated or not with cataract surgery facilitate the exit of aqueous humor through the trabecular meshwork (TM) have been described. Our aim in this chapter is to review the newest of them, such as the following: iStent; ELT (Excimer Laser Trabeculostomy); kahook; ABiC; and OMNI.

scholarly journals Two‐year outcomes of minimally invasive XEN Gel Stent implantation in primary open‐angle and pseudoexfoliation glaucoma

2020 ◽  
Author(s):  
Teresa Rauchegger ◽  
Reinhard Angermann ◽  
Peter Willeit ◽  
Eduard Schmid ◽  
Barbara Teuchner
Keyword(s):  
Minimally Invasive ◽  
Stent Implantation ◽  
Open Angle ◽  
Pseudoexfoliation Glaucoma ◽  
Xen Gel Stent

Postoperative complications in glaucoma surgery: literature review-based recommendations to improve reporting consistency

2021 ◽  
pp. bjophthalmol-2021-318952
Author(s):  
Francesco Stringa ◽  
Alan Kastner ◽  
Dale Heuer ◽  
Keith Barton ◽  
Anthony J King
Keyword(s):  
Systematic Review ◽  
Postoperative Complications ◽  
Meaning Making ◽  
Surgical Complication ◽  
Surgical Techniques ◽  
Glaucoma Surgery ◽  
Surgical Trials ◽  
Registration Number ◽  
Surgery Research ◽  
Time Frames

AimsTo recommend a list of complications of glaucoma surgery to be used in future glaucoma surgery research and reporting by exploring the spectrum of complications’ names, the variety of definitions and time frames used for reporting them in glaucoma surgical trials.MethodsComplications’ names, definitions and time frames identified from a previously conducted systematic review of glaucoma surgery trials (registration number: CRD42019121226) were reviewed. Only postoperative complications were considered. Surgical techniques described in the papers from the previous systematic review were retrieved and grouped according their mechanism of action.Reviewers independently recommended each complication’s inclusion or exclusion in a list to be proposed as a potential standard for reporting in glaucoma interventions. A literature-based definition of a ‘surgical complication’ was used to inform these decisions. Recorded complication’s details were used to inform the development of clinically relevant definitions, a consensus-driven exercise between reviewers resolved disagreements.ResultsWe identified 48/111 (43.2%) of the reported complications as suitable for inclusion, of which 17 were merged into other included complications having a broader meaning making up a final table of 32 postoperative complications. For 25 of them, the authors kept ‘names’ that were previously used in the systematic review, but provided a definition that was not mentioned in these papers. Five included complications were given both ‘names’ and definitions not previously mentioned. The authors maintained the name and definition for one complication. There were 16 complications that were in common to all the procedures retrieved from the previous review.ConclusionsWe propose a table of revised names and comprehensive definitions of postoperative complications, to simplify the process of reporting complications after glaucoma surgery and to improve consistency among surgical trials.

Advances in the Surgical Management of Glaucoma—The Role of the EX-PRESS® Glaucoma Filtration Device

2012 ◽  
Vol 05 (02) ◽  
pp. 81
Author(s):  
David W Cope ◽  
Robert Fechtner ◽  
Leo de Jong ◽  
Malik Kahook ◽  
Marlene Moster ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Surgical Techniques ◽  
Glaucoma Surgery ◽  
Medical Laser ◽  
Minimally Invasive Glaucoma Surgery ◽  
High Degree ◽  
Fine Tune ◽  
Glaucoma Filtration Device ◽  
Filtration Device

By reducing intraocular pressure (IOP), we aim to arrest the glaucomatous process. Our strategies include medical, laser, and surgical techniques. Trabeculectomy is the gold standard drainage surgery to achieve this; as there can be a high degree of variability in the procedure and its success depends on bleb creation, with the challenges of wound healing modulation, results remain unpredictable. Several devices are being assessed to try to achieve ‘minimally invasive glaucoma surgery’. While results will take some years to evaluate rigorously, it seems IOP levels by these means lie in the mid-teens. These minimally invasive glaucoma surgery techniques therefore would appear to be destined for patients whose glaucomatous damage is relatively mild to moderate and whose target IOPs fall into this range. To simultaneously achieve lower IOPs for patients with more advanced visual loss, efforts have been made to ‘fine-tune’ trabeculectomy. Use of the EX-PRESS® Glaucoma Filtration Device (GFD) under a scleral flap is one such approach. How does the EX-PRESS® GFD benefit the conventional trabeculectomy procedure? What tips and tricks contribute to its success? How safe is it? Is the additional cost to our health systems justifiable? This symposium, sponsored by Alcon, set out to try to answer these questions.

scholarly journals Combining Ab Interno Kahook Trabeculectomy with Gonioscopy-Assisted Transluminal Trabeculotomy Reduces Intraocular Pressure

2019 ◽  
Vol 184 (11-12) ◽  
pp. 934-936
Author(s):  
Jared R Widder ◽  
Joseph W Schmitz
Keyword(s):  
Intraocular Pressure ◽  
Surgical Technique ◽  
Open Angle Glaucoma ◽  
Glaucoma Surgery ◽  
Active Duty ◽  
Pharmacologic Therapy ◽  
Open Angle ◽  
Elevated Intraocular Pressure ◽  
Kahook Dual Blade ◽  
Ab Interno

Abstract Minimally invasive glaucoma surgery (MIGS) provides a safe option for individuals with mild to moderate open-angle glaucoma to reduce their need for pharmacologic therapy or more extensive ab externo surgeries. In this report, we describe a surgical technique using both the Kahook Dual Blade and Gonioscopy-assisted transluminal trabeculotomy (GATT), to treat a 23-year-old active duty female with idiopathic uveitis and subsequent corticosteroid-induced glaucoma who presented with consistently elevated intraocular pressure (IOP) measurements despite maximal pharmacologic interventions. This combination was effective in consistently lowering intraocular pressure for at least 12 months in a young, phakic, active duty patient with uveitis and steroid-responsive open-angle glaucoma.

scholarly journals Minimally invasive glaucoma surgery - current and emerging techniques to reduce intraocular pressure and medications

2021 ◽  
Vol 2021 ◽  
Author(s):  
Krishna Komzak ◽  
Philip Rothschild ◽  
Joobin Hooshmand ◽  
Penny Allen ◽  
Tze’Yo Toh
Keyword(s):  
Intraocular Pressure ◽  
Minimally Invasive ◽  
Glaucoma Surgery ◽  
Minimally Invasive Glaucoma Surgery

scholarly journals Double-Needle Yamane Repositioning of a Previous Yamane Fixation

2019 ◽  
Vol 10 (3) ◽  
pp. 431-437
Author(s):  
Sangeethabalasri Pugazhendhi ◽  
Balamurali Ambati ◽  
Allan A. Hunter
Keyword(s):  
Intraocular Pressure ◽  
Visual Impairment ◽  
Optic Disc ◽  
Surgical Techniques ◽  
Ultrasound Biomicroscopy ◽  
Fundus Examination ◽  
Antihypertensive Medications ◽  
Safety And Efficacy ◽  
Elevated Intraocular Pressure ◽  
Capsular Support

We describe a case of anteriorly dislocated, Yamane-fixated secondary intraocular lens (IOLs) with pigmentary dispersion syndrome. The patient presented with significant visual impairment and elevated intraocular pressure despite being maximally treated with all topical antihypertensive medications. The iris-IOL touch was confirmed by ultrasound biomicroscopy, and fundus examination revealed evidence of pigment granules on the optic disc. The previous Yamane-fixated secondary IOL was repositioned using a double-needle adaptation of Yamane technique and Kim’s modification of scleral-fixated IOLs. To our knowledge, this is the first ever documented case of double-needle Yamane technique of a previous Yamane-fixated eye. In cases of inadequate capsular support, the development of new surgical techniques for the fixation of IOL continues to improve the safety and efficacy of these complicated surgeries.

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