XEN辅助的Baerveldt植入失败：小儿患者的三种不同翻修方法

XEN-augmented Baerveldt Failure: Three Different Revision Approaches for Pediatric Patients.

作者信息

José Patrícia, Pinto Luís Abegão, Teixeira Filipa Jorge

机构信息

Department of Ophthalmology, Centro Hospitalar Universitário Lisboa Norte, Hospital Santa Maria, Lisboa, Portugal; Ophthalmology University Clinic, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal; Vision Sciences Study Center, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal.

出版信息

J Curr Glaucoma Pract. 2021 May-Aug;15(2):96-98. doi: 10.5005/jp-journals-10078-1307.

DOI:10.5005/jp-journals-10078-1307

PMID:34720500

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8543748/

Abstract

AIM AND OBJECTIVE

Report three different solutions in case of XEN-augmented Baerveldt fails.

BACKGROUND

Drainage devices have been used for refractory pediatric glaucoma. To avoid early hypotony and corneal damage, Mermoud et al. introduced the augmentation of a XEN implant with a Baerveldt tube. In some cases, this technique fails to lead to a high intraocular pressure (IOP) and surgical revision.

CASE DESCRIPTION

Three cases of children with this combined implant needed surgical revision due to high IOP. Three different approaches were performed: XEN replacement in one case, stretching the Baerveldt's tube into the anterior chamber (AC) in the second case, and explant of the device followed by an implant of a new Baerveldt-250 in the same quadrant in the third case. Successful control of IOP (>18 mm Hg) was achieved in all patients under no topical treatment.

CONCLUSION

Despite the attractiveness of the XEN-augmented Baerveldt implant in refractory pediatric glaucoma as an alternative to conventional surgery, we have to learn how to deal with failures. Three different approaches are presented with good short-term results. The long-term efficacy is yet to be assessed.

CLINICAL SIGNIFICANCE

Describe three possible options when faced with a need for surgical revision in XEN-augmented Baerveldt implant.

HOW TO CITE THIS ARTICLE

José P, Abegão Pinto L, Teixeira FJ. XEN-augmented Baerveldt Failure: Three Different Revision Approaches for Pediatric Patients. J Curr Glaucoma Pract 2021;15(2):96-98.

摘要

目的

报告XEN增强型Baerveldt植入物失败时的三种不同解决方案。

背景

引流装置已用于难治性儿童青光眼。为避免早期低眼压和角膜损伤，Mermoud等人引入了用Baerveldt管增强XEN植入物的方法。在某些情况下，该技术未能导致高眼压和手术翻修。

病例描述

三例使用这种联合植入物的儿童因高眼压需要进行手术翻修。采用了三种不同的方法：一例更换XEN，第二例将Baerveldt管延伸至前房，第三例取出装置并在同一象限植入新的Baerveldt-250。所有患者在未进行局部治疗的情况下眼压均成功控制在>18 mmHg。

结论

尽管XEN增强型Baerveldt植入物作为传统手术的替代方案在难治性儿童青光眼中具有吸引力，但我们必须学会如何应对失败情况。本文介绍了三种不同的方法，短期效果良好。长期疗效尚待评估。

临床意义

描述在XEN增强型Baerveldt植入物需要手术翻修时的三种可能选择。

如何引用本文

José P, Abegão Pinto L, Teixeira FJ. XEN-augmented Baerveldt Failure: Three Different Revision Approaches for Pediatric Patients. J Curr Glaucoma Pract 2021;15(2):96-98.