Journal of Current Glaucoma Practice

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VOLUME 18 , ISSUE 2 ( April-June, 2024 ) > List of Articles

CASE REPORT

Reviving XEN63 Gel Stent Patency in Uveitic Glaucoma: A Novel Approach Using 10-0 Nylon Probe

Vincenzo Marchese, Viviana Randazzo, Rosanna Badalamenti, Marco Anastasi

Keywords : Case report, Minimally invasive glaucoma surgery, Uveitic glaucoma, XEN63 implant

Citation Information : Marchese V, Randazzo V, Badalamenti R, Anastasi M. Reviving XEN63 Gel Stent Patency in Uveitic Glaucoma: A Novel Approach Using 10-0 Nylon Probe. J Curr Glaucoma Pract 2024; 18 (2):74-78.

DOI: 10.5005/jp-journals-10078-1445

License: CC BY-NC 4.0

Published Online: 10-07-2024

Copyright Statement:  Copyright © 2024; The Author(s).


Abstract

Purpose: This case report describes the possibility of XEN63 lumen obstruction at the middle of the device and emphasizes the potential to restore its flow using an ab-externo revision technique involving a 10-0 nylon suture probe, before considering more aggressive surgical interventions. Methods: A 55-year-old female with uveitic glaucoma underwent XEN63 implantation but experienced elevated intraocular pressure (IOP) (35 mm Hg) 1 month after the operation, despite medical therapy. A flat bleb, lack of response to medication, yttrium aluminum garnet (YAG) laser treatment, and slit-lamp needling necessitated revision. Results: An ab-externo surgical procedure was performed using a 10-0 nylon probe to release the obstruction, followed by the application of mitomycin C and removal of fibrous tissue and subconjunctival Tenon's capsule. Intraoperatively, flow was observed only after probing with the 10-0 nylon. Postoperatively, the patient's IOP decreased immediately and remained well-controlled at 2 months (8 mm Hg) without requiring further medication. Conclusion: For patients experiencing increased inflammatory response, the XEN63 gel stent may develop deep lumen occlusion that is unresponsive to conventional treatments. This case report introduces a novel surgical technique applicable to various glaucoma devices, utilizing an ab-externo approach with a 10-0 nylon probe. The demonstrated success in reducing IOP suggests its potential as a less invasive alternative to consider before resorting to more aggressive surgical interventions.


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