Journal of Current Glaucoma Practice

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VOLUME 15 , ISSUE 2 ( May-August, 2021 ) > List of Articles

CASE REPORT

XEN-augmented Baerveldt Failure: Three Different Revision Approaches for Pediatric Patients

Patrícia José, Luís Abegão Pinto, Filipa Jorge Teixeira

Keywords : Baerveldt tube, Case review, Childhood glaucoma, XEN implant

Citation Information : José P, Pinto LA, Teixeira FJ. XEN-augmented Baerveldt Failure: Three Different Revision Approaches for Pediatric Patients. J Curr Glaucoma Pract 2021; 15 (2):96-98.

DOI: 10.5005/jp-journals-10078-1307

License: CC BY-NC 4.0

Published Online: 30-09-2021

Copyright Statement:  Copyright © 2021; The Author(s).


Abstract

Aim and objective: Report three different solutions in case of XEN-augmented Baerveldt fails. Background: Drainage devices have been used for refractory pediatric glaucoma. To avoid early hypotony and corneal damage, Mermoud et al. introduced the augmentation of a XEN implant with a Baerveldt tube. In some cases, this technique fails to lead to a high intraocular pressure (IOP) and surgical revision. Case description: Three cases of children with this combined implant needed surgical revision due to high IOP. Three different approaches were performed: XEN replacement in one case, stretching the Baerveldt's tube into the anterior chamber (AC) in the second case, and explant of the device followed by an implant of a new Baerveldt-250 in the same quadrant in the third case. Successful control of IOP (>18 mm Hg) was achieved in all patients under no topical treatment. Conclusion: Despite the attractiveness of the XEN-augmented Baerveldt implant in refractory pediatric glaucoma as an alternative to conventional surgery, we have to learn how to deal with failures. Three different approaches are presented with good short-term results. The long-term efficacy is yet to be assessed. Clinical significance: Describe three possible options when faced with a need for surgical revision in XEN-augmented Baerveldt implant.


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