Department of Ophthalmology, University Hospital, Dijon.
Quinze-Vingts National Eye Hospital, Univ Paris 06-Sorbonne Universities.
J Glaucoma. 2019 Mar;28(3):e37-e40. doi: 10.1097/IJG.0000000000001146.
The purpose of this study was to report a case of recurrent conjunctival erosion and XEN Gel Stent exposure after implantation in a primary open-angle glaucoma patient. Minimally invasive glaucoma surgery (MIGS) is a new approach in glaucoma surgery, and there is a lack of published data with regard to the management of postoperative ocular surface complications.
This is a case report of a patient with a persistent corneal erosion after XEN Gel Stent implantation. A standalone MIGS surgery was planned for both eyes in this case of refractory glaucoma. Despite a first surgical revision, the patient was suffering from a chronic leaking bleb, an exposed XEN Gel Stent, and severe hypotonia in the left eye.
A free conjunctival autografting technique covered with a complementary amniotic membrane graft was performed under local anesthesia. One month following bleb revision, the intraocular pressure was 13 mm Hg on medical treatment, and slit-lamp examination showed a well-formed moderate bleb with no leakage.
This is the first described case of the use of a free conjunctival autograft to treat a persistently leaking bleb after XEN Gel Stent implantation. This case highlights the potential complication of conjunctival erosion due to XEN Gel Stent implantation. It emphasizes the management of complicated filtration blebs after MIGS surgery.
本研究旨在报告一例原发性开角型青光眼患者植入 XEN 凝胶支架后反复出现结膜侵蚀和 XEN 凝胶支架暴露的病例。微创青光眼手术（MIGS）是青光眼手术的一种新方法，对于术后眼表并发症的处理，目前缺乏相关数据。
这是一例 XEN 凝胶支架植入后持续性角膜侵蚀患者的病例报告。该难治性青光眼患者双眼均计划行独立的 MIGS 手术。尽管进行了第一次手术修正，但患者左眼仍存在慢性渗漏性滤泡、暴露的 XEN 凝胶支架和严重的低眼压。
在局部麻醉下，采用游离结膜自体移植技术覆盖补充羊膜移植。在进行滤泡修正后 1 个月，患者在药物治疗下眼压为 13mmHg，裂隙灯检查显示形成良好的中度滤泡，无渗漏。
这是首例描述使用游离结膜自体移植治疗 XEN 凝胶支架植入后持续性渗漏滤泡的病例。该病例强调了 XEN 凝胶支架植入后发生结膜侵蚀的潜在并发症，并突出了 MIGS 手术后处理复杂滤过性滤泡的重要性。
