Posters

XEN glaucoma implant for treatment of secondary glaucoma due to elevated episcleral venous pressure

Poster Details

First Author: M.Teus SPAIN

Co Author(s): G. Bolivar-De-Miguel   B. Casta�o   M. Garcia-Gonzalez   A. Katsanos           

Abstract Details

Purpose:

To describe the result of XEN implant as the first surgical option in a patient with secondary glaucoma due to elevated episcleral pressure. As it is known certain conditions in which episcleral venous pressure is pathologically elevated result in secondary glaucoma, and one of these conditions are patients with arteriovenous fistula. When glaucoma surgery is necessary in these patients is essential to reduce the risk of hypotony, choroidal effusion, suprachoroidal hemorrhage.

Setting:

Clínica Novovisión, Madrid, Spain. Príncipe de Asturias Hospital, University of Alcalá, Alcalá de Henares, Madrid, Spain.

Methods:

We present the case of a 70-year-old female who was referred for glaucoma consultation to our institution. Best corrected visual acuity in the right (RE) and the left eye (LE) was 0.8 and 0.9 respectively and intraocular pressure (IOP) was 15 mmHg in RE and 20 mmHg in LE under treatment of three topical medications. The slit lamp examination showed pseudophakia and prominent episcleral and conjunctival vessels with conjunctival chemosis in both eyes. Optical Coherence Tomography showed severely damaged retinal nerve fibers in LE whereas that was normal in RE.

Results:

Due to the glaucoma damage in the LE a XEN ® implant associated with mitomycin C was carried out uneventfully. After this procedure the IOP was reduced and well controlled. The XEN stent is an implant designed according to Hagen-Poiseuille, its length and width try to achieve a flow restriction and thus a differential pressure along the tube to achieve decrease the IOP while avoiding hypotony. In patients with elevated episcleral pressure the Xen implant may provide a flow restriction that can avoid some of the early complications that may appear when the episcleral pressure is elevated.

Conclusions:

In conclusion, when medical treatment is not enough, insertion of XEN ® stent might be a good option for treating glaucoma in patients with elevated episcleral venous pressure.

Financial Disclosure:

None