Posters

Corneal decompensation secondary to the CyPass microstent

Poster Details

First Author: T.Jenyon UK

Co Author(s):    B. Ilango                    

Abstract Details

Purpose:

To described a case of corneal decompensation secondary to minimally invasive glaucoma surgery. To highlight the difficulty in managing these patients. To suggest an incidence via retrospective audit.

Setting:

Wolverhampton Eye Infirmary

Methods:

Case report and retrospective audit of all patients at our unit who had a Cypass microstent (Alcon) insertion in the last 5 years.

Results:

The patient was referred with localised corneal oedema overlying the tip of a Cypass microstent (Alcon).  Corneal endothelial cell count was reduced compared to the other eye. The stent tip was located in close proximity to the corneal endothelium. A further 2 cases out of a cohort of 50 patients at our unit have been identified with localised corneal decompensation.

Conclusions:

This case may represent the beginnings of a new cohort of patients needing management by the corneal team.  The management of these patients is difficult. The stents are not advised to be repositioned.  Fibrosis around and through the stent may ensure it is unable to be repositioned or removed even if attempted. We suggest regular follow up, with regular corneal cell count monitoring. Gonioscopy to identify high risk patients with protruding stents.  If surgical treatment is required, trimming the stent combined with an endothelial transplant may be the most successful option.

Financial Disclosure:

None