Ab interno removal of malpositioned ex-press glaucoma device combined with bleb needling.

IF 2.1 3区医学 Q2 OPHTHALMOLOGY

Japanese Journal of Ophthalmology Pub Date : 2025-05-07 DOI:10.1007/s10384-025-01203-5

Daigo Kobayashi, Tadamichi Akagi, Tetsuya Togano, Ryu Iikawa, Takeo Fukuchi

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引用次数: 0

Abstract

Purpose: We present an ab interno removal technique combined with a needling procedure for a malpositioned Ex-PRESS glaucoma shunt.

Study design: Retrospective case series.

Methods: This study examined four cases of malpositioned Ex-PRESS shunts. Needle bleb revision was performed to expand the space under the scleral flap and bleb area. Clinical data, including corneal endothelial cell density (ECD), intraocular pressure (IOP), and anterior segment optical coherence tomography images (AS-OCT), were retrieved from clinical records.

Results: All four cases underwent ab interno shunt removal combined with needle bleb revision without any serious complications. In three cases of anterior shunt malposition, a reduction in ECD was apparent before surgery but remained relatively stable after surgery. In one patient with posterior shunt malposition, shunt occlusion was suspected before surgery, but bleb formation and IOP improved after surgery. IOP was 8 mmHg to 21 mmHg (median, 10.5 mmHg) before surgery and 5 mmHg to 17 mmHg (median, 10 mmHg) 12 months after surgery. No additional glaucoma surgery was required within the first 12 months; however, after 12 months, two patients required additional glaucoma surgery.

Conclusion: Ab interno Ex-PRESS device removal combined with bleb needling is an important procedure in patients with malpositioned Ex-PRESS devices.

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青光眼置错装置联合泡针内取出术。

目的：我们提出了一种结合针入术的腹腔内摘除技术来治疗错位的Ex-PRESS青光眼分流术。研究设计:回顾性病例系列。方法：对4例错位的Ex-PRESS分流器进行分析。采用针泡修补术扩大巩膜瓣下的空间和泡区。从临床记录中检索临床数据，包括角膜内皮细胞密度（ECD）、眼内压（IOP）和前段光学相干断层扫描图像（AS-OCT）。结果：4例患者均行腹腔分流术切除联合针泡修复术，无严重并发症。在3例前分流错位病例中，术前ECD明显降低，但术后保持相对稳定。1例后分流管错位患者术前怀疑分流管闭塞，但术后水泡形成及IOP改善。术前IOP为8 ~ 21 mmHg（中位数为10.5 mmHg），术后12个月IOP为5 ~ 17 mmHg（中位数为10 mmHg）。在最初的12个月内不需要额外的青光眼手术；然而，12个月后，两名患者需要额外的青光眼手术。结论：Ab interno Ex-PRESS器械取出联合水泡针刺是治疗Ex-PRESS器械放置不正确的重要方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Japanese Journal of Ophthalmology 医学-眼科学

CiteScore

4.80

自引率

8.30%

发文量

审稿时长

6-12 weeks

期刊介绍： The Japanese Journal of Ophthalmology (JJO) was inaugurated in 1957 as a quarterly journal published in English by the Ophthalmology Department of the University of Tokyo, with the aim of disseminating the achievements of Japanese ophthalmologists worldwide. JJO remains the only Japanese ophthalmology journal published in English. In 1997, the Japanese Ophthalmological Society assumed the responsibility for publishing the Japanese Journal of Ophthalmology as its official English-language publication. Currently the journal is published bimonthly and accepts papers from authors worldwide. JJO has become an international interdisciplinary forum for the publication of basic science and clinical research papers.