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Abstract #90310 Published in IGR 21-3
Laser Iridoplasty to Treat Iris-occluded XEN Gel Stent
Tadrosse AF; Khouri ASJournal of Glaucoma 2020; 29: e91-e92
PURPOSE: To provide the first report on argon laser peripheral iridoplasty (ALPI) to restore XEN-45 Gel stent patency after iris occlusion. METHODS: Case description, laser technique, and relevant clinical imaging. RESULTS: A 53-year-old African American male patient presented with progressive advanced stage primary open-angle glaucoma. Initial intraocular pressure (IOP) was 40 mm Hg, which continued to be elevated despite maximal medical therapy and selective laser trabeculoplasty. The patient underwent an uncomplicated XEN-45 Gel stent implantation and presented with an IOP of 4 mm Hg 5 days postoperatively with a functioning bleb. On postoperative day 10, the XEN lumen was found to be occluded by the iris with an IOP spike of 39 mm Hg. Anti-glaucoma treatment to induce miosis and liberate the stent was unsuccessful. ALPI was attempted to relieve the obstruction. IOP dropped to 26 mm Hg immediately post-ALPI and continued to be well-controlled 6 months later (11 mm Hg). CONCLUSIONS: ALPI can effectively restore XEN Gel stent patency if occluded by the iris and should be considered before attempting more invasive surgical revisions.
Institute of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark, NJ.
Full articleClassification:
12.3 Laser iridoplasty (Part of: 12 Surgical treatment)
12.8.2 With tube implant or other drainage devices (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
