Villarreal Eloy, Berkowitz Eran, Tiosano Beatrice
Department of Ophthalmology, Hillel Yaffe Medical Center Affiliated with the Bruce Rappaport School of Medicine, The Technion-Israel Institute of Technology, Haifa, Israel.
Case Rep Ophthalmol Med. 2023 Nov 22;2023:7096406. doi: 10.1155/2023/7096406. eCollection 2023.
To introduce a potential solution for failed glaucoma surgeries by proposing an optional surgical procedure in conjunction with the use of Healaflow (Anteis S.A., Geneva, Switzerland) as a spacer, which may potentially reduce the failure rate. . We present the outcomes of a surgical procedure involving the inferonasal implantation of an ab interno XEN gel stent (Allergan, Dublin, Ireland) in a 74-year-old male patient who was experiencing uncontrolled advanced glaucoma in his left eye. It is important to note that the patient had previously undergone several glaucoma surgeries and procedures in the same eye. During this particular procedure, we utilized Healaflow as a spacer by implanting the stent within a subconjunctival Healaflow "bubble." At 6 months postoperatively, intraocular pressure remained on target. There was no need for additional topical medications, and no change in visual acuity was observed.
For patients with a history of unsuccessful glaucoma surgeries and who are unsuitable candidates for tube shunt procedures or transscleral diode cyclophotocoagulation, an alternative option involves implanting the XEN45 stent in the inferior nasal region in conjunction with the use of subconjunctival Healaflow. This combined approach may provide a potential solution for managing glaucoma in these patients.
通过提出一种可选的手术方法,并结合使用Healaflow(瑞士日内瓦的Anteis S.A.公司)作为间隔物,介绍一种针对青光眼手术失败的潜在解决方案,这可能会降低失败率。我们展示了一名74岁男性患者的手术结果,该患者左眼患有无法控制的晚期青光眼,接受了鼻内植入XEN凝胶支架(爱尔兰都柏林的Allergan公司)的手术。需要注意的是,该患者此前在同一只眼睛上已经接受过多次青光眼手术和治疗。在这次特定的手术中,我们通过将支架植入结膜下Healaflow“气泡”内,将Healaflow用作间隔物。术后6个月,眼压保持在目标范围内。无需额外使用局部药物,视力也没有变化。
对于有青光眼手术失败史且不适合进行管分流手术或经巩膜二极管睫状体光凝术的患者,另一种选择是在鼻下区域植入XEN45支架并结合使用结膜下Healaflow。这种联合方法可能为这些患者的青光眼治疗提供一种潜在的解决方案。