Surgical management of complicated inflammatory glaucoma.

GMS ophthalmology cases Pub Date : 2020-11-10 eCollection Date: 2020-01-01 DOI:10.3205/oc000170
Glenda Espinosa-Barberi, Francisco José Galván González, David Peláez Viera
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引用次数: 1

Abstract

Case report: We report a case of a 26-year-old woman with a previous history of complicated ulcerative colitis, as well as multiple episodes of recurrent anterior uveitis in control with adalimumab and methotrexate, who develops ocular hypertension refractory to topical treatment. The implant of an EXPRESS® is proposed, but in the immediate post-operative period, the implant causes atalamia and does not achieve the correct control of intraocular pressure. A XEN® stent was implanted. Due to failure, it was decided to remove the stent and to release a subconjunctival fibrosis that had formed at the subconjunctival portion of the XEN®, in association with coating by an Ologen® collagen matrix, which led to an improvement of the results. Conclusions: The surgical management of inflammatory glaucoma is complex in young patients with a scar component. The new minimally invasive techniques are effective in cases refractory to topical treatment, whose characteristics prevent the use of conventional ones.

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并发炎性青光眼的手术治疗。
病例报告:我们报告了一例26岁的女性,既往有复杂的溃疡性结肠炎病史,并多次发作复发性前葡萄膜炎,用阿达木单抗和甲氨蝶呤控制,并发眼压升高,局部治疗难治性。我们提出了EXPRESS®植入术,但在术后不久的一段时间内,植入术导致失智,无法实现正确的眼压控制。植入XEN®支架。由于失败,我们决定移除支架并释放在XEN®结膜下部分形成的结膜下纤维化,并用Ologen®胶原基质涂层,这导致了结果的改善。结论:有瘢痕成分的青光眼的手术治疗是复杂的。新的微创技术对局部治疗难治性的病例有效,其特点阻止了传统方法的使用。
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