PDF(Pubmed)
Abstract：
BACKGROUND: Xen Gel Stent implant is a new minimally invasive surgical treatment for glaucoma that has been proven effectiveness and safety profile. However, it may also lead to some complications. Xen Gel Stent occlusion is a relatively rare complication reported less frequently and has limited treatment experience. In our case report, we proposed a novel surgical treatment using a 10 - 0 nylon suture to successfully recanalize the occluded Xen45 Gel Stent.
METHODS: A 16-year-old female patient had bilateral juvenile glaucoma for the past 5 years. Her right eye had undergone three glaucoma surgeries but failed. At a presentation to our hospital, the right eye\'s intraocular pressure (IOP) was 30 mmHg despite applying four different active principles. Xen45 Gel Stent implant was chosen for treatment, but six days after implantation, the IOP rose to 40 mmHg as a result of an anterior chamber tip occlusion of the Xen45 Gel Stent. Nd: YAG laser shockwave therapy was attempted but failed. The patient eventually had to return to the operating room for a revision procedure. The Xen45 Gel Stent was recanalized from the ab externo by making an L-shaped conjunctival incision at the fornix base and threading a 10 - 0 nylon suture through it. The IOP was successfully controlled in the 11-month follow-up without medication.
CONCLUSIONS: If postoperative occlusion arises after Xen45 Gel Stent implantation, surgery using 10 - 0 nylon suture to recanalize Xen45 Gel Stent should be considered as a relatively safe, effective that does not require removal of Xen45 Gel Stent.
METHODS: A 16-year-old female patient had bilateral juvenile glaucoma for the past 5 years. Her right eye had undergone three glaucoma surgeries but failed. At a presentation to our hospital, the right eye\'s intraocular pressure (IOP) was 30 mmHg despite applying four different active principles. Xen45 Gel Stent implant was chosen for treatment, but six days after implantation, the IOP rose to 40 mmHg as a result of an anterior chamber tip occlusion of the Xen45 Gel Stent. Nd: YAG laser shockwave therapy was attempted but failed. The patient eventually had to return to the operating room for a revision procedure. The Xen45 Gel Stent was recanalized from the ab externo by making an L-shaped conjunctival incision at the fornix base and threading a 10 - 0 nylon suture through it. The IOP was successfully controlled in the 11-month follow-up without medication.
CONCLUSIONS: If postoperative occlusion arises after Xen45 Gel Stent implantation, surgery using 10 - 0 nylon suture to recanalize Xen45 Gel Stent should be considered as a relatively safe, effective that does not require removal of Xen45 Gel Stent.
摘要：
背景：Xen凝胶支架植入物是一种新型的青光眼微创手术治疗方法，已被证明具有有效性和安全性。然而,它也可能导致一些并发症。Xen凝胶支架闭塞是一种相对罕见的并发症，报道频率较低，治疗经验有限。在我们的案例报告中，我们提出了一种新的手术治疗方法，使用10-0尼龙缝合线，成功地将阻塞的Xen45凝胶支架再通。
方法：一名16岁女性患者在过去5年中患有双侧幼年性青光眼。她的右眼经历了三次青光眼手术，但失败了。在我们医院的介绍会上，尽管应用了4种不同的活性成分,但右眼的眼内压(IOP)为30mmHg.选择Xen45凝胶支架植入物进行治疗，但是植入后六天，由于Xen45凝胶支架的前房尖闭塞，IOP升至40mmHg。尝试使用Nd:YAG激光冲击波治疗，但失败。患者最终不得不返回手术室进行翻修手术。通过在穹窿基部制作L形结膜切口并将10-0尼龙缝合线穿过它，将Xen45凝胶支架从外侧再通。随访11个月,无药物治疗成功控制眼压。
结论：如果Xen45凝胶支架植入后出现术后闭塞，手术使用10-0尼龙缝线再通Xen45凝胶支架应被认为是相对安全的，有效，不需要去除Xen45凝胶支架。
方法：一名16岁女性患者在过去5年中患有双侧幼年性青光眼。她的右眼经历了三次青光眼手术，但失败了。在我们医院的介绍会上，尽管应用了4种不同的活性成分,但右眼的眼内压(IOP)为30mmHg.选择Xen45凝胶支架植入物进行治疗，但是植入后六天，由于Xen45凝胶支架的前房尖闭塞，IOP升至40mmHg。尝试使用Nd:YAG激光冲击波治疗，但失败。患者最终不得不返回手术室进行翻修手术。通过在穹窿基部制作L形结膜切口并将10-0尼龙缝合线穿过它，将Xen45凝胶支架从外侧再通。随访11个月,无药物治疗成功控制眼压。
结论：如果Xen45凝胶支架植入后出现术后闭塞，手术使用10-0尼龙缝线再通Xen45凝胶支架应被认为是相对安全的，有效，不需要去除Xen45凝胶支架。
