Abstract：
BACKGROUND: To discuss the efficacy of an inferior implant of XEN 63 gel stent in a patient with refractory glaucoma after trabeculectomy failure and vitreoretinal surgery with silicone oil tamponade.
METHODS: We report the case of a 73-year-old man with a history of refractory open glaucoma with trabeculectomy failure. He experienced recurrent retinal detachments with silicone oil tamponade, with uncontrolled intra-ocular pressure (IOP) after silicone oil removal. Due to the presence of oil emulsion in the anterior chamber, the chosen location for XEN 63 implantation was the infero-temporal quadrant. Mild hyphema and vitreous hemorrhage were seen post-operatively, but were self-limiting. At week 1, the intraocular pressure was 8 mmHg with a well-formed bleb seen in anterior segment optical coherence tomography (AS-OCT). At 6 month follow up, the patient maintained a IOP of 12 mmHg without topical hypotensive drugs. Slit lamp examination revealed a widespread, developed bleb with no signs of inflammation.
CONCLUSIONS: In this case of refractory glaucoma in a vitrectomized eye with previous oil tamponade, the inferior placement of the XEN 63 gel stent delivered an adequate intraocular pressure even at 6-months follow up, with a diffuse functional infero-nasal bleb seen with AS-OCT.
METHODS: We report the case of a 73-year-old man with a history of refractory open glaucoma with trabeculectomy failure. He experienced recurrent retinal detachments with silicone oil tamponade, with uncontrolled intra-ocular pressure (IOP) after silicone oil removal. Due to the presence of oil emulsion in the anterior chamber, the chosen location for XEN 63 implantation was the infero-temporal quadrant. Mild hyphema and vitreous hemorrhage were seen post-operatively, but were self-limiting. At week 1, the intraocular pressure was 8 mmHg with a well-formed bleb seen in anterior segment optical coherence tomography (AS-OCT). At 6 month follow up, the patient maintained a IOP of 12 mmHg without topical hypotensive drugs. Slit lamp examination revealed a widespread, developed bleb with no signs of inflammation.
CONCLUSIONS: In this case of refractory glaucoma in a vitrectomized eye with previous oil tamponade, the inferior placement of the XEN 63 gel stent delivered an adequate intraocular pressure even at 6-months follow up, with a diffuse functional infero-nasal bleb seen with AS-OCT.
摘要：
背景：探讨下植入XEN63凝胶支架治疗1例小梁切除术失败和玻璃体视网膜手术硅油填塞术后难治性青光眼的疗效。
方法：我们报告一例73岁男性，有难治性开放性青光眼伴小梁切除术失败病史。他经历了硅油填塞的复发性视网膜脱离，硅油去除后眼内压（IOP）不受控制。由于前房存在油乳剂，选择的XEN63植入位置是颞下象限.术后可见轻度前房积血和玻璃体出血，而是自我限制。在第1周，眼内压为8mmHg，在眼前段光学相干断层扫描（AS-OCT）中可见形成良好的气泡。随访6个月时，患者维持IOP为12mmHg,未使用局部降压药.裂隙灯检查显示，出现气泡，没有炎症迹象。
结论：在这种情况下，在玻璃体切除的眼睛中出现了难治性青光眼，即使在6个月的随访中，XEN63凝胶支架的下方放置也能提供足够的眼压，AS-OCT可见弥漫性功能性鼻下出血。
方法：我们报告一例73岁男性，有难治性开放性青光眼伴小梁切除术失败病史。他经历了硅油填塞的复发性视网膜脱离，硅油去除后眼内压（IOP）不受控制。由于前房存在油乳剂，选择的XEN63植入位置是颞下象限.术后可见轻度前房积血和玻璃体出血，而是自我限制。在第1周，眼内压为8mmHg，在眼前段光学相干断层扫描（AS-OCT）中可见形成良好的气泡。随访6个月时，患者维持IOP为12mmHg,未使用局部降压药.裂隙灯检查显示，出现气泡，没有炎症迹象。
结论：在这种情况下，在玻璃体切除的眼睛中出现了难治性青光眼，即使在6个月的随访中，XEN63凝胶支架的下方放置也能提供足够的眼压，AS-OCT可见弥漫性功能性鼻下出血。
