Detorakis Efstathios T, Villamarin Adan, Roy Sylvain, Bigler Stephane, Bontzos Georgios, Stergiopulos Constantinos, Stergiopulos Nikos
Department of Ophthalmology, University Hospital of Heraklion, Crete, Greece.
Laboratory of Hemodynamics and Cardiovascular Technology, Lausanne, Switzerland.
J Curr Glaucoma Pract. 2020 May-Aug;14(2):64-67. doi: 10.5005/jp-journals-10078-1276.
The eyeWatch™ is a novel device in glaucoma surgery aiming at the control of aqueous flow through the use of an external magnetic control unit. We propose the modification of this approach through the use of an injectable perforated tube rather than a plated valve.
Procedures were performed at the Department of Ophthalmology of the University of Crete. Three blind painful eyes of three patients were included. All patients were operated under topical anesthesia. A purpose designed blunt-ended injector was used to insert intraorbitally a perforated 4 cm-long silicone tube. The tube was then connected to an eyeWatch™ device which was placed in a standard fashion along the superior-temporal quadrant of the eyeball. The procedure was uneventful in cases I and II, whereas in case III the tube had to be trimmed by 1.5 cm because of cicatricial changes in the orbit. The eyeWatch™ was left closed (position VI) at the conclusion of surgeries. Patients were examined on the 1-day, 1-week, 2-week, 1-month, 3-month, and 6-month intervals and in one case on the 12-month interval.
No major complications were observed. The intraocular pressure (IOP) remained under 15 mm Hg without anti-glaucomatous medications in all postoperative intervals in cases I and 2 with readjustment of eyeWatch™ at position IV. In case III, despite the change of the eyeWatch™ to the open position, the IOP remained high (40 mm Hg).
The combination of the eyeWatch™ with an insertable perforated tube instead of a standard non-valved plate may prove a valid minimally invasive option. Modifications of the technique, such as an increased number and diameter of tube perforations, increased inserted tube length, perhaps aided by a sharp-ended injector, and selection of the insertion quadrant, may increase the effectiveness of the method.
eyeWatch™ combined with a single tube instead of a plated valve is a feasible, quick, and minimally invasive technique that can be used in glaucoma surgery.
Detorakis ET, Villamarin A, Roy S, eyeWatch™ System Combined with Non-plated Intraorbital Tube Insertion for the Management of Refractory Glaucoma: A Case Series. J Curr Glaucoma Pract 2020;14(2):64-67.
eyeWatch™是青光眼手术中的一种新型设备，旨在通过使用外部磁控单元来控制房水流动。我们建议通过使用可注射的多孔管而非平板瓣膜来改进这种方法。
手术在克里特大学眼科进行。纳入了3例患者的3只失明疼痛眼。所有患者均在表面麻醉下进行手术。使用专门设计的钝头注射器将一根4厘米长的多孔硅胶管眶内插入。然后将该管连接到eyeWatch™设备，该设备以标准方式沿眼球颞上象限放置。病例I和II的手术过程顺利，而病例III由于眼眶瘢痕形成，管子不得不修剪1.5厘米。手术结束时，eyeWatch™保持关闭状态（位置VI）。患者在术后第1天、1周、2周、1个月、3个月和6个月进行检查，1例患者在12个月时进行检查。
未观察到重大并发症。病例I和2在术后各时间段内，在未使用抗青光眼药物的情况下，眼压保持在15毫米汞柱以下，eyeWatch™重新调整到位置IV。病例III中，尽管eyeWatch™变为打开位置，但眼压仍然很高（40毫米汞柱）。
将eyeWatch™与可插入的多孔管而非标准的无瓣膜平板相结合可能是一种有效的微创选择。对该技术进行改进，如增加管子穿孔的数量和直径、增加插入管的长度（可能借助尖头注射器）以及选择插入象限，可能会提高该方法的有效性。
eyeWatch™与单根管而非平板瓣膜相结合是一种可行、快速且微创的技术，可用于青光眼手术。
Detorakis ET, Villamarin A, Roy S, eyeWatch™系统联合非平板眶内管插入术治疗难治性青光眼：病例系列。《当代青光眼实践杂志》2020年；14(2):64 - 67。
