Journal of Current Glaucoma Practice

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VOLUME 13 , ISSUE 3 ( September-December, 2019 ) > List of Articles


Management of Persistent Hypotony after Supraciliary CyPass® Implantation Using Argon Laser

Del Valle-Nava Fernando, Díez-Cattini GF, García-López Alfonso, Ortega-Santana Francisco

Keywords : CyPass®, Glaucoma surgery, Hypotony, Minimally invasive glaucoma surgery, Supraciliary microstent

Citation Information : Fernando DV, GF D, Alfonso G, Francisco O. Management of Persistent Hypotony after Supraciliary CyPass® Implantation Using Argon Laser. J Curr Glaucoma Pract 2019; 13 (3):116-118.

DOI: 10.5005/jp-journals-10078-1259

License: CC BY-NC 4.0

Published Online: 11-07-2020

Copyright Statement:  Copyright © 2019; The Author(s).


Purpose: To report a case and management of persistent hypotony with hypotony-induced maculopathy after CyPass® device implant. Background: The CyPass® was the first supraciliary ab interno device approved by FDA and commercially available. Efficacy studies showed adequate intraocular pressure (IOP)-lowering results in combination with phacoemulsification. Hypotony induced by suprachoroidal minimally invasive glaucoma surgery (MIGS) was reported to be lower than 3% in the population that comprised the COMPASS study. Case description: A 57-year-old female patient with mild open-angle glaucoma with maximum topical medical therapy who underwent sequential bilateral CyPass® implantation developed persistent hypotony. Device obstruction was induced through argon laser burns directed to the peripheral iris, and the device was no longer visible on follow-up examinations. Topical IOP-lowering medication was restarted (timolol–dorzolamide) and has since been controlled under 16 mm Hg, without progression on visual fields. Conclusion: Argon laser burns directed to the peripheral iris to induce synechiae development that produces device obstruction are an effective technique to manage persistent hypotony after supraciliary CyPass® implantation. Clinical significance: Here, authors show a novel approach for treatment of persistent hypotony secondary to CyPass® implantation. In the knowledge of the authors, this is the first report that describes a noninvasive management for this complication, and this case could help other physicians to manage similar cases.

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