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[玻璃体切除术后高度近视眼中:微创青光眼手术植入物的禁忌证?]

[High myopia in vitrectomized eyes : Contraindication for minimally invasive glaucoma surgery implant?].

作者信息

Huth A, Viestenz A

机构信息

Universitätsklinik und Poliklinik für Augenheilkunde, Universitätsklinikum Halle, Martin-Luther-Universität Halle-Wittenberg, Ernst-Grube-Str. 40, 06120, Halle, Deutschland.

出版信息

Ophthalmologe. 2020 May;117(5):461-466. doi: 10.1007/s00347-019-00950-4.

Abstract

Minimally invasive glaucoma surgery (MIGS) implants, such as XEN® gel stent are additional procedures in glaucoma treatment, which were designed to reduce the postoperative risk of severe hypotony and further complications. Until now the contraindications for every implant have not yet been identified. This case report describes the disastrous follow-up after implantation of a XEN® gel stent in the only high myopic eye of a patient. Despite elaborate subsequent interventions massive choroidal hemorrhage occurred with loss of the remaining visual field and total loss of visual acuity. The ocular pressure could be stabilized only after explantation of the XEN® gel stent. Patients with high myopia and the associated thin sclera, vitrectomized eyes and previous treatment with mitomycin C should be selected very carefully for XEN® gel stent. If these criteria are present the XEN® gel stent should be avoided whenever possible.

摘要

微创青光眼手术(MIGS)植入物,如XEN®凝胶支架,是青光眼治疗中的额外手术,旨在降低术后严重低眼压和进一步并发症的风险。到目前为止,尚未确定每种植入物的禁忌症。本病例报告描述了一名患者仅有的高度近视眼中植入XEN®凝胶支架后的灾难性随访情况。尽管随后进行了精心的干预,但仍发生了大量脉络膜出血,剩余视野丧失,视力完全丧失。仅在取出XEN®凝胶支架后眼压才得以稳定。对于高度近视以及伴有薄巩膜、玻璃体切除术后的眼睛和先前接受丝裂霉素C治疗的患者,在选择XEN®凝胶支架时应非常谨慎。如果存在这些标准,应尽可能避免使用XEN®凝胶支架。

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