Universität zu Köln

Widder, Randolf Alexander, Rennings, Corinna and Roessler, Gernot F. (2020). Open conjunctival revision after XEN45 gel stent implantation as a standardized procedure A step by step guide. Video article. Ophthalmologe, 117 (8). S. 806 - 811. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1433-0423

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Abstract

Background After implantation of a XEN gel stent scarring of the conjunctiva with elevation of the intraocular pressure (IOP) is a frequent occurrence. This article describes a surgical revision technique with opening of the conjunctiva and removal of scar tissue. In order to standardize the technique the surgical procedure was divided into nine steps. These steps are shown in the video and a series of images. Methods Surgery is divided into nine steps: 1) corneal traction suture and topical application of suprarenin, 2) opening of the conjunctiva along the limbus, 3) preparation posteriorly towards the fornix, 4) separation of the stent from the surrounding scar tissue, 5) precise preparation of the stent, 6) removal of additional scar tissue not adhering to the stent, 7) functional testing of the stent, 8) mitomycin C application, 9) closing of the conjunctiva with two corner sutures on the limbus. Results After surgery a diffuse filtering bleb is formed. In the literature increased success rates up to 90% (criterion: no further surgery necessary) after open conjunctival revision have been described. Severe side effects are not to be expected and are comparable to those of primary surgery. Conclusion Open revision of the conjunctiva after XEN gel stent implantation leads to an effective and enduring lowering of IOP. Revision surgery can be carried out even after a long time period and can keep the patient free of antiglaucomatous drops. Experience in surgery of filtering blebs is advantageous when performing open revision of the conjunctiva.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Widder, Randolf Alexander UNSPECIFIED UNSPECIFIED UNSPECIFIED Rennings, Corinna UNSPECIFIED UNSPECIFIED UNSPECIFIED Roessler, Gernot F. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-330720
DOI:	10.1007/s00347-020-01127-0
Journal or Publication Title:	Ophthalmologe
Volume:	117
Number:	8
Page Range:	S. 806 - 811
Date:	2020
Publisher:	SPRINGER HEIDELBERG
Place of Publication:	HEIDELBERG
ISSN:	1433-0423
Language:	German
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language GLAUCOMA; SURGERY; SUCCESS; SAFETY Multiple languages Ophthalmology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/33072