Posters

The treatments of hypertrophic bleb after XEN gel implantation with ’drainage channel with suture’ method

Poster Details

First Author: K.Yavuzer TURKEY

Co Author(s):    A. Meşen                    

Abstract Details

Purpose:

In this case report, we aimed to present a hypertrophic bleb complication after third month of XEN gel implantation and evaluat this complication management.

Setting:

University of Health Sciences, Van Training and Research Hospital, Ophthalmology Clinic, Van, Turkey.

Methods:

A 75-year-old patient who recently was accepted for a decrease in vision and  treated for glaucoma appealed to the clinic. He had pseudoexfoliation glaucoma and corticonuclear cataract. Cataract combined glaucoma surgery was planned to patient and XEN45 gel implantation was performed from the upper-nasal quadrant after phacoemulsification and intraocular lens implantation. In the first three months, intraocular pressure (IOP) was ranged from 9-13 mmHg without drug use and no complications were determined. At the third month control, bleb was seen at 180 degrees of nasal quadrant which caused ectropion of the lower eyelid and value of IOP was 12 mmHg.

Results:

Considering that this large bleb is linked to overfiltration, topical/systemic carbonic anhydrase treatment and tight closure were performed. Although the IOP of 7 mmHg after treatment there was not any change on size of the bleb. This clinic was thought to be hypertrophic bleb and the bleb was evacuated by deciding on surgery. In order to avoid recurrence “Drainage Channel with Suture” extending from both sides of the XEN gel implant to the globe equator was created. While the nasal conjunctiva and the lower eyelid forme were observed in the patient's controls, IOP was measured at around 13 mmHg.

Conclusions:

Minimally invasive glaucoma surgery aims to provide a safer and less invasive way of keeping IOP in the normal range for reducing topical medication compared with conventional surgery. XEN gel stent is an ab-interno minimally invasive glaucoma surgery which provides a subconjunctival drainage pathway and decreases intraocular pressure. As with every new method, there is a lack of experience and knowledge about long-term outcomes in terms of effectiveness, technique and complications. In this case report, mid-term complication of XEN gel implant and management of this complication are discussed.

Financial Disclosure:

None