The treatment of a hypertrophic bleb after XEN gel implantation with the “Drainage Channel with sutures” method: a case report

Yavuzer, Kamil; Meşen, Ali

doi:10.1186/s12886-019-1249-0

Cited by 8 publications

(6 citation statements)

References 7 publications

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“…Repeated tapping was performed upon the bleb size and symptoms. Yavuzer demonstrated a technique using a drainage channel with sutures to manage this complication [ 33 ]; however, surgical techniques for avoiding this problem are not yet available.…”

Section: Discussionmentioning

confidence: 99%

24-month outcomes of XEN45 gel implant versus trabeculectomy in primary glaucoma

Wanichwecharungruang

Ratprasatporn

2021

PLoS ONE

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Purpose To compare the efficacy and safety profiles of XEN implant versus trabeculectomy as a surgical intervention for primary glaucoma Methods A retrospective cohort study of mild to moderate stage glaucoma patients, who had undergone either XEN implantation or trabeculectomy with adjunctive mitomycin C, was performed in a tertiary eye center Results Fifty-seven eyes for XEN implant and 57 eyes for trabeculectomy with medically uncontrolled glaucoma were included. Preoperative IOP was 16–33 mmHg. Visual field mean deviation was -9.11±6.93 dB in XEN group, and -9.67±5.06 dB in trabeculectomy group (p = 0.195). At the 24-month timepoint, mean IOP was reduced from 21.6±4.0 to 14.6±3.5 mmHg (32.4% reduction) in the XEN group (p<0.001), and from 22.5±5.8 to 12.5±4.1 mmHg (44.4% reduction) in the trabeculectomy group (p<0.001). Final IOP in XEN was significantly higher than trabeculectomy (p = 0.008) with lesser mean IOP percentage reduction at month 24 (p = 0.045). Mean number of medications was reduced from 2.2±1.4 to 0.5±0.7 in XEN group (p<0.001), and from 2.4±0.7 to 0.8±1.3 in trabeculectomy group (p<0.001). Final number of medications was not different between the groups (p = 0.225). Surgical success was comparable between XEN and trabeculectomy group. Overall success was 71.4% vs. 73.3% (p = 0.850), and complete success was 62.9% vs. 62.2% (p = 0.954), respectively. XEN had lower rate of numerical hypotony than trabeculectomy. No serious complication occurred in either procedure group. Conclusion At 24 months, XEN showed a rate of success comparable to that of trabeculectomy. Although XEN had a higher final IOP than trabeculectomy, XEN achieved 32% IOP reduction, and achieved final IOP in mid-teen level. No serious complication occurred in either group. XEN can be applied for treatment of mild to moderate stages of glaucoma in Southeast Asian patients.

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Section: Discussionmentioning

confidence: 99%

24-month outcomes of XEN45 gel implant versus trabeculectomy in primary glaucoma

Wanichwecharungruang

Ratprasatporn

2021

PLoS ONE

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“…Yavuzer et al 53 reported a case of a 75-year-old male patient with PXG who underwent a Xen 45 combo with 0.1 mL 0.2 mg/mL of MMC. Three months postoperatively, unmedicated IOP varied between 9 and 13 mmHg.…”

Section: Dysesthetic Blebmentioning

confidence: 99%

<p>XEN<sup>®</sup> Gel Stent: A Comprehensive Review on Its Use as a Treatment Option for Refractory Glaucoma</p>

Fea¹,

Durr²,

Marolo³

et al. 2020

OPTH

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The XEN Gel Microstent is a subconjunctival microinvasive glaucoma surgical device developed with the aim of improving the predictability and safety profile of blebforming glaucoma surgical procedures. The stent is a hydrophilic tube composed of a porcine gel cross-linked with glutaraldehyde with good stability and biocompatibility with minimal tissue reaction. This device has demonstrated promising outcomes with fewer risks compared to traditional surgeries. The aim of the review is to present early studies on different designs of the XEN Gel Stent, to summarize different surgical techniques of implantation and to analyze more comprehensively the results, complications and rates of needling of the commercially available device (Xen 45). The review will address separately special cases (PXG, UVG, ICE, congenital glaucoma) and describe small series and case reports.

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“…That notwithstanding, a nylon 10-0 suture has been previously employed with ab externo Xen implantation to reduce post-operative rate of erosion after subconjunctival Xen placement [ 11 ]. Also, Yavuzer and Meşen employed the “drainage channel with sutures” to treat a hypertrophic bleb complication which developed after the third month of Xen gel implantation [ 12 ]. This is the first report, to our knowledge, to treat an inferonasal hypertrophic bleb complication with fixation suture.…”

Section: Discussion/conclusionmentioning

confidence: 99%

The Use of Fixation Suture to Treat Inferonasal Hypertrophic Bleb after Xen Gel Stent Implant: A Case Report

Pavičić-Astaloš¹,

Ankamah

Nolan

et al. 2022

Case Rep Ophthalmol

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We report a case of an inferonasal hypertrophic bleb complication which formed 5 months after Xen Gel Stent implantation for intraocular pressure (IOP) control in a primary open-angle glaucoma patient and its management using a fixation suture. The patient underwent an uneventful right-eye phacoemulsification and intraocular lens implantation combined with Xen Gel Stent ab interno implantation surgery. A month after the surgery, a second needling was performed due to a flat bleb and increased IOP. Post-needling slit-lamp examination showed a well-formed diffuse bleb in the superonasal quadrant. Two months after the needling, the patient presented with redness and irritation medially. Upon examination, a large inferonasal bleb was observed together with scarring of a previously formed superior bleb above the Xen Gel Stent implant. Fornix-based conjunctival incision technique was used to release the conjunctival scarring, and a fixation suture was used for the Xen implant in order to change the filtration direction. A Palmberg compression mattress suture was used to stop the inferior filtration. Despite an open conjunctiva surgical revision in the superior quadrant, no additional scaring was formed in the follow-up period of 20 months. There was good post-operative IOP control and formation of superiorly positioned bleb. To our knowledge, this is the first report to describe the use of a fixation suture for treating inferonasal hypertrophic bleb as a late complication of Xen Gel Stent implantation surgery.

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The treatment of a hypertrophic bleb after XEN gel implantation with the “Drainage Channel with sutures” method: a case report

Cited by 8 publications

References 7 publications

24-month outcomes of XEN45 gel implant versus trabeculectomy in primary glaucoma

24-month outcomes of XEN45 gel implant versus trabeculectomy in primary glaucoma

<p>XEN<sup>®</sup> Gel Stent: A Comprehensive Review on Its Use as a Treatment Option for Refractory Glaucoma</p>

The Use of Fixation Suture to Treat Inferonasal Hypertrophic Bleb after Xen Gel Stent Implant: A Case Report

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