TY - JOUR
T1 - Intraoperative suprachoroidal hemorrhage during Xen gel stent implantation
AU - Liu, James C.
AU - Green, Wesley
AU - Sheybani, Arsham
AU - Lind, John T.
N1 - Publisher Copyright:
© 2020 The Author(s)
PY - 2020/3
Y1 - 2020/3
N2 - Purpose: To report a rare case of intraoperative suprachoroidal hemorrhage during Xen gel stent implantation with accompanying surgical video and subsequent 6-month follow-up. Observations: Our patient required incisional glaucoma surgery after inadequate pressure reduction with four classes of topical medication, methazolamide, and selective laser trabeculoplasty. The patient underwent Xen gel stent implantation and developed an intraoperative suprachoroidal hemorrhage, which was managed in the operating room. The patient recovered his baseline visual acuity with a functioning bleb out to 6 months postoperatively. Conclusions and Importance: Micro-invasive glaucoma surgeries offer a new repertoire of surgical options, purportedly with safer and less invasive techniques. Xen gel stent implantation may be a promising alternative to traditional trabeculectomies and tube shunt implants, providing similar IOP lowering results with potentially lower risk for complications. However, rare and severe complications such as suprachoroidal hemorrhage may still occur. Recognizing a suprachoroidal bleed, particularly intraoperatively, will still be necessary to help minimize the potential vision threatening sequelae often associated with this severe complication.
AB - Purpose: To report a rare case of intraoperative suprachoroidal hemorrhage during Xen gel stent implantation with accompanying surgical video and subsequent 6-month follow-up. Observations: Our patient required incisional glaucoma surgery after inadequate pressure reduction with four classes of topical medication, methazolamide, and selective laser trabeculoplasty. The patient underwent Xen gel stent implantation and developed an intraoperative suprachoroidal hemorrhage, which was managed in the operating room. The patient recovered his baseline visual acuity with a functioning bleb out to 6 months postoperatively. Conclusions and Importance: Micro-invasive glaucoma surgeries offer a new repertoire of surgical options, purportedly with safer and less invasive techniques. Xen gel stent implantation may be a promising alternative to traditional trabeculectomies and tube shunt implants, providing similar IOP lowering results with potentially lower risk for complications. However, rare and severe complications such as suprachoroidal hemorrhage may still occur. Recognizing a suprachoroidal bleed, particularly intraoperatively, will still be necessary to help minimize the potential vision threatening sequelae often associated with this severe complication.
KW - Glaucoma
KW - Hypotony
KW - Intraoperative complication management
KW - Micro-invasive glaucoma surgery (MIGS)
KW - Suprachoroidal bleeding
KW - Suprachoroidal hemorrhage
KW - Xen gel stent implantation
UR - http://www.scopus.com/inward/record.url?scp=85078653595&partnerID=8YFLogxK
U2 - 10.1016/j.ajoc.2020.100600
DO - 10.1016/j.ajoc.2020.100600
M3 - Article
C2 - 32025590
AN - SCOPUS:85078653595
SN - 2451-9936
VL - 17
JO - American Journal of Ophthalmology Case Reports
JF - American Journal of Ophthalmology Case Reports
M1 - 100600
ER -