Franco Fabrizio, Serino Federica, Giansanti Fabrizio
Neuromuscular and Sense Organs Department, Eye Clinic, Careggi University Hospital, 50139 Florence, Italy.
Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, 50139 Florence, Italy.
Vision (Basel). 2023 Nov 2;7(4):71. doi: 10.3390/vision7040071.
We aimed to describe a variation of the surgical technique for the ab interno implantation of the XEN Gel Stent, which, in our experience, is yielding very successful results. The injection of 0.1 mL of air and then of 0.1 mL of a dispersive viscoelastic into the subconjunctival space at the beginning of the surgery allows one to perform a mechanical dissection between the conjunctiva and the Tenon's capsule, creating a real space. In total, 20 eyes of 16 patients underwent the implantation of a stent gel through the "Air and Visco" technique. We retrospectively analyzed the results. We obtained a reduction in the IOP from an average of 18.3 ± 2.2 mmHg preoperatively to at 13.5 ± 3.5 mmHg at month 12. The needling rate was 20%. We did not register any cases of hypotony (IOP < 6 mmHg), hypotony maculopathy or choroidal detachment. The "Air and Visco" technique allows one to correctly place the device in the subconjunctival space, which the pneumo- and visco-dissection transforms into a real space. This enables an easier surgical performance and more predictable postoperative results, with a low needling rate and reintervention in the follow-up period. It also ensures a greater safety profile because the presence of the OVD on the bleb prevents a sudden lowering of the IOP, eliminating complications such as hypotony, hypotony maculopathy and choroidal detachment in our cohort.
我们旨在描述一种XEN凝胶支架眼内植入手术技术的变体，根据我们的经验，该技术取得了非常成功的结果。手术开始时，在结膜下间隙注射0.1 mL空气，然后注射0.1 mL分散性粘弹性物质，这样可以在结膜和Tenon囊之间进行机械分离，形成一个真正的空间。共有16例患者的20只眼睛通过“空气和粘弹剂”技术植入了凝胶支架。我们对结果进行了回顾性分析。眼压从术前平均18.3±2.2 mmHg降至术后12个月时的13.5±3.5 mmHg。针刺率为20%。我们未记录到任何低眼压（眼压<6 mmHg）、低眼压性黄斑病变或脉络膜脱离的病例。“空气和粘弹剂”技术可将装置正确放置在结膜下间隙，气-粘弹剂分离将该间隙转化为一个真正的空间。这使得手术操作更容易，术后结果更可预测，针刺率低，随访期间再次干预少。它还确保了更高的安全性，因为在滤过泡处存在眼前段粘弹剂可防止眼压突然降低，消除了我们队列中的低眼压、低眼压性黄斑病变和脉络膜脱离等并发症。
