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Novel treatment (new drug/intervention; established drug/procedure in new situation)
CASE REPORT
Baerveldt-XEN persistent proximal occlusion: solving new problems with old answers
  1. Filipa Teixeira1,2,
  2. Filipa Caiado1,2,
  3. Paula Sens1,2,
  4. Luis Abegão Pinto1,2,3
  1. 1Department of Ophthalmology, Hospital de Santa Maria, Lisboa, Portugal
  2. 2Clínica Universitária de Oftalmologia, Faculdade de Medicina, Universidade de Lisboa, Portugal
  3. 3Centro de Estudos das Ciências da Visão, Lisboa, Portugal
  1. Correspondence to Professor Luis Abegão Pinto, abegaopinto{at}gmail.com

Summary

A 51-year-old woman was referred with uncontrolled intraocular pressure (IOP) despite maximal medical IOP-lowering therapy. Her background included several failed glaucoma filtering surgeries, including aqueous drainage devices. Considering the need to perform surgery in a patient with both scarred conjunctiva and corneal endothelial deficiency, a surgical technique combining cornea-friendly XEN stent connected to a large-plate Baerveldt glaucoma implant was undertaken. Unfortunately, XEN implants obstructed twice during the early postoperative period. As further XEN replacements were unfeasible, there was the need to bridge the gap between the Baerveldt tube and the anterior chamber. An easy accessible, cheap 22G angiocatheter segment was used for this purpose. With a follow-up of 6 months, there were no postoperative complications nor loss of efficiency, with IOP of 7 mmHg. Tube extension using angiocatheter is a viable, cost-effective option in these difficult cases, saving the surgeon from having to explant and replace the entire implant.

  • glaucoma
  • anterior chamber

https://doi.org/10.1136/bcr-2018-226958

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    Footnotes

    • Contributors FC and LAP were responsible for the patient’s diagnosis. PS and LAP were responsible for patient management. FT was involved with the acquisition of data. FT and LAP were involved in the conception and design of the case report. All authors were involved in the interpretation of data and critical revision of this article.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.