Delayed Suprachoroidal Hemorrhage After Xen45 Gel Stent.

Autor: Pham AH; Bascom Palmer Eye Institute, University of Miami Miller School of Medicine., Junk AK; Bascom Palmer Eye Institute, University of Miami Miller School of Medicine.; Miami Veterans Affairs Medical Center, Miami, FL.
Jazyk: angličtina
Zdroj: Journal of glaucoma [J Glaucoma] 2023 Apr 01; Vol. 32 (4), pp. e33-e35. Date of Electronic Publication: 2023 Feb 03.
DOI: 10.1097/IJG.0000000000002181
Abstrakt: Prcis: In patients with significant preoperative comorbidities, prolonged activity restrictions beyond 2 weeks after Xen45 surgery may mitigate the risks of delayed SCH.
Purpose: To report the first case to date of delayed suprachoroidal hemorrhage (SCH) not associated with hypotony 2 weeks after the placement of the Xen45 gel stent.
Case Summary: An 84-year-old white man with significant cardiovascular comorbidities underwent uneventful ab externo implantation of a Xen45 gel stent for asymmetric progression of severe primary open angle glaucoma. The patient had a reduction in intraocular pressure by 11 mm Hg on postoperative day 1 and maintained preoperative visual acuity. The intraocular pressure remained stable at 8 mm Hg on multiple postoperative visits until the patient developed a SCH at postoperative week 2 immediately after a light session of physical therapy. The patient was treated medically with topical cycloplegic, steroid, and aqueous suppressants. He maintained preoperative visual acuity throughout the postoperative course and had resolving SCH without the need for surgical intervention.
Conclusions: This is the first report of a delayed presentation of SCH in the absence of hypotony after ab externo implantation of the Xen45 device. The possibility of this vision-threatening complication should be considered as part of the risk assessment and included in the consent process for the gel stent. In patients with significant preoperative comorbidities, prolonged activity restrictions beyond 2 weeks after Xen45 surgery may mitigate the risks of delayed SCH.
Competing Interests: Disclosure: The authors declare no conflict of interest.
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Databáze: MEDLINE