Department of Ophthalmology, PHHYKY, Lahti, Finland.
J Glaucoma. 2018 Oct;27(10):926-928. doi: 10.1097/IJG.0000000000001022.
To describe a new surgical method for treating late profound hypotony in 2 patients with glaucoma drainage implant (GDI).
Two patients, an 85-year-old woman and a 44-year-old woman, presented with choroidal effusions secondary related to chronic hypotony after GDI surgery. A novel technique was performed in both cases to narrow the lumen size of the GDI tube. The GDI tube was exposed and ligated temporarily with a polyglactin suture in both cases. The anterior part of the capsule wall was opened. The Xen stent was removed from its injector and pushed through the posterior orifice of the GDI tube. The whole Xen stent was inserted inside the tube to narrow the lumen size of the GDI tube. Once the Xen had been placed inside the tube lumen, a silk suture was tied around the GDI tube to secure the Xen in position. The ligation suture of the GDI tube was removed and suturing of the conjunctiva was performed.
Before restriction of aqueous flow through the GDI, both patients had an intraocular pressure (IOP) of 2 mm Hg and blurry vison of 20/40 to 20/200. Following the Xen implant insertion, IOP ranged between 8 and 20 mm Hg and choroidal effusions resolved, and visual acuity improved. In both cases, IOP remained stable through 1 year of follow-up and no choroidal effusions or macular folds were noticed.
A Xen implant placed inside the GDI tube offers an option for the treatment of chronic hypotony in eyes with GDI.
描述 2 例青光眼引流植入（GDI）术后迟发性深度低眼压患者的新手术方法。
2 例患者，1 例 85 岁女性，1 例 44 岁女性，均因 GDI 术后慢性低眼压继发脉络膜积液。在这两种情况下，均采用一种新的技术来缩小 GDI 管的管腔大小。GDI 管均暴露并临时用聚乳酸缝线结扎。在前房内切开囊壁的前壁。将 Xen 支架从其注射器中取出并从 GDI 管的后孔推送。将整个 Xen 支架插入管内，以缩小 GDI 管的管腔大小。一旦 Xen 支架被放置在管腔内部，就在 GDI 管周围系上丝线以将 Xen 支架固定在位。移除 GDI 管的结扎缝线并缝合结膜。
在限制 GDI 房水流动之前，两名患者的眼压（IOP）均为 2mmHg，视力模糊为 20/40 至 20/200。Xen 支架植入后，IOP 范围在 8 至 20mmHg 之间，脉络膜积液消退，视力提高。在这两种情况下，IOP 在 1 年的随访中均保持稳定，并且没有发现脉络膜积液或黄斑皱褶。
Xen 支架置于 GDI 管内为 GDI 眼慢性低眼压的治疗提供了一种选择。
