XEN in secondary glaucoma after congenital cataract surgery

Session Details

Session Title: Presented Poster Session: Glaucoma

Venue: Poster Village: Pod 2

First Author: : J.Dabad Moreno SPAIN

Co Author(s): :    R. Cordero Ros   C. Lavin Dapena   A. Ramos Castrillo   R. Langa Hontoria   R. Montejano Milner           

Abstract Details

Purpose:

We present a case of refractory glaucoma (GR) to medical treatment in the left eye (LE) secondary to congenital cataract (CC) in both eyes (BE) with good control of intraocular pressure (IOP) after implantation of XEN device (Allergan).

Setting:

La Paz University Hospital

Methods:

A patient with BE CC developed secondary glaucoma after undergone lensectomy and intraocular lens implant. Blind painful right eye was eviscerated after two Ahmed valve failures; LE failed Ahmed valve was replaced by a trabeculectomy. At the age of 19, IOP raised over 38mmHg despite triple therapy. Oral Acetazolamide tablet was added twice a day. LE visual acuity was 20/60. Slit-lamp examination showed clear cornea, wide chamber and pseudophakia. Papilla had no glaucomatous appearance and cup-to-disc ratio was 0'3. OCT showed neuroretinal fibers thickness of 74 μm with affected upper and lower quadrants. Blind spot slight increased slightly in campimetry.

Results:

We started four active drugs without achieving good control of IOP in successive revisions, also patient developed intolerance to oral acetazolamide. We propose the need for surgery and decided to implant "ab internal" XEN tube. It was performed in the upper nasal quadrant with mitomycin 0´02% presenting as a complication a mild bleeding after placement. In the immediate postoperative period, cornea was a transparent, wide anterior chamber, slight hyphema and hyposphagma. We performed a gonioscopy to localize the implant. In all postoperative studies up to 9 months, IOP reduction was maintained below 14mmHg without hypotensive treatment.

Conclusions:

The XEN implant is effective in reducing IOP in a GR without response to medical treatment, easy to handle and with minimal complications.

Financial Disclosure:

None