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Complications after CyPass® Micro-Stent explantation: a case series

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Abstract

Purpose

To describe the in toto explantation of the CyPass® Micro-Stent and its conceivable complications.

Methods

This is a case series of eighteen eyes from fourteen patients who underwent CyPass® Micro-Stent implantation due to mild to moderate glaucoma and who subsequently suffered from loss of endothelial cell density. Consequently, the CyPass® Micro-Stent was in toto explanted. The surgical procedure and its complications are described and compared with trimming of the CyPass® Micro-Stent.

Results

A postoperative hyphema was developed in 8 of the 18 eyes. In four of them the hyphema was self-limiting, while in two patients an anterior chamber irrigation was necessary. One patient suffered from a severe intracameral bleeding and iridodialysis during explantation, so that the base of the iris had to be scleral fixated. The remaining explantations were without complications.

Conclusion

Dealing with implanted CyPass® Micro-Stents poses a challenge for ophthalmic surgeons. An in toto removal can be traumatic, since the CyPass stent often is fibrotic encapsulated and fused with the surrounding tissue. Alternatively, trimming of the CyPass is also a viable option to avoid further endothelial damage. Reported complications of CyPass trimming are consistent with those that can occur after explantation. Further data on the development of the endothelial cells after trimming or explantation are not yet available. Therefore, it remains open whether trimming of the CyPass, in contrast to complete removal, carries the risk of further endothelial cell loss.

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References

  1. Ansari E (2017) An update on implants for minimally invasive glaucoma surgery (migs). Ophthalmol Ther 6(2):233–241. https://doi.org/10.1007/s40123-017-0098-2

    Article  PubMed  PubMed Central  Google Scholar 

  2. Weinreb RN, Aung T, Medeiros FA (2014) The pathophysiology and treatment of glaucoma: a review. JAMA 311(18):1901–1911. https://doi.org/10.1001/jama.2014.3192

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Schoelles KJ, Anton A, Auw-Haedrich C (2020) Chronic granulomatous inflammation after Cypass® implantation. Ocul Oncol Pathol 6(4):259–264. https://doi.org/10.1159/000505491

    Article  PubMed  PubMed Central  Google Scholar 

  4. Reiss G, Clifford B, Vold S et al (2019) Safety and effectiveness of cypass supraciliary micro-stent in primary open-angle glaucoma: 5-year results from the compass xt study. Am J Ophthalmol 208:219–225. https://doi.org/10.1016/j.ajo.2019.07.015

    Article  PubMed  Google Scholar 

  5. Höh H, Grisanti S, Grisanti S, Rau M, Ianchulev S (2014) Two-year clinical experience with the cypass micro-stent: safety and surgical outcomes of a novel supraciliary micro-stent. Klin Monbl Augenheilkd 231(4):377–381. https://doi.org/10.1055/s-0034-1368214

    Article  PubMed  Google Scholar 

  6. Fili S, Seddig S, Vastardis I, Perdikakis G, Wölfelschneider P, Kohlhaas M (2021) explantation of the cypass implant in a case series of patients with corneal decompensation. Ophthalmologe 118(1):42–49. https://doi.org/10.1007/s00347-020-01106-5

    Article  CAS  PubMed  Google Scholar 

  7. Grisanti S, Margolina E, Hoeh H et al (2014) supraciliary microstent for open-angle glaucoma: clinical results of a prospective multicenter study. Ophthalmologe 111(6):548–552. https://doi.org/10.1007/s00347-013-2927-6

    Article  CAS  PubMed  Google Scholar 

  8. Vold S, Ahmed IIK, Craven CR et al (2016) Two-year compass trial results: supraciliary microstenting with phacoemulsification in patients with open-angle glaucoma and cataracts. Ophthalmology 123(10):2103–2012. https://doi.org/10.1016/j.ophtha.2016.06.032

    Article  PubMed  Google Scholar 

  9. Fili S, Seddig S, Papadopoulou E, Kohlhaas M (2019) one-year results after cypass implantation. Ophthalmologe 116(5):447–455. https://doi.org/10.1007/s00347-018-0745-6

    Article  CAS  PubMed  Google Scholar 

  10. https://www.alcon.com/media-release/alcon-announces-voluntary-global-market-withdrawal-cypass-micro-stent-surgical, Accessed 11 June 2023

  11. Rose C, Schargus M (2022) cypass microstent trimming with special cutting forceps : video article. Ophthalmologe 119(4):421–424. https://doi.org/10.1007/s00347-022-01596-5

    Article  PubMed  Google Scholar 

  12. Habbe KJ, Kohlhaas M, Langwieder C, Fili S (2022) Foreign body reaction after cypass® micro-stent implantation: a case series. Graefes Arch Clin Exp Ophthalmol. https://doi.org/10.1007/s00417-022-05767-7

    Article  PubMed  Google Scholar 

  13. Medra A, Schwanengel M, Weber A, Brinkmann CK (2020) Microsurgical trimming of the cypass stent : surgical procedure of the neubrandenburg eye clinic. Ophthalmologe 117(12): 1241–1246. https://doi.org/10.1007/s00347-020-01247-7

  14. Grewal AM, Singh M, Yadav D et al (2021) Long-term ophthalmic anatomical and functional outcomes after surgical removal of intraorbital foreign bodies. Eur J Ophthalmol 31(1):263–270. https://doi.org/10.1177/1120672119885587

    Article  PubMed  Google Scholar 

  15. Huang YM, Yan H, Cai JH, Li HB (2017) Removal of intraocular foreign body in anterior chamber angle with prism contact lens and 23-gauge foreign body forceps. Int J Ophthalmol 10(5):749–753. https://doi.org/10.18240/ijo.2017.05.15

    Article  PubMed  PubMed Central  Google Scholar 

  16. Hübner L, Schlötzer-Schrehardt U, Weller JM, Hohberger B, Mardin CY, Lämmer R (2022) Ultrastructural analysis of explanted cypass microstents and correlation with clinical findings. Graefes Arch Clin Exp Ophthalmol 260(8):2663–2673. https://doi.org/10.1007/s00417-022-05620-x

    Article  PubMed  PubMed Central  Google Scholar 

  17. Lass JH, Benetz BA, He J et al (2019) Corneal endothelial cell loss and morphometric changes 5 years after phacoemulsification with or without cypass micro-stent. Am J Ophthalmol 208:211–218. https://doi.org/10.1016/j.ajo.2019.07.016

    Article  PubMed  Google Scholar 

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Funding

The authors declare that no funds, grants or other support were received during the preparation of this manuscript.

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Authors and Affiliations

  1. Department of Ophthalmology at St. Johannes Hospital in Dortmund, Johannesstraße 9-13, 44137, Dortmund, Germany

    Kirsten J. Habbe MD, Markus Kohlhaas MD, PhD & Sofia Fili MD, PhD

Authors
  1. Kirsten J. Habbe MD
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  2. Markus Kohlhaas MD, PhD
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  3. Sofia Fili MD, PhD
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by SF and KH. The first draft of the manuscript was written by KH and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Kirsten J. Habbe MD.

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Conflict of interest

The authors have no relevant financial or non-financial interests to disclose.

Ethics approval

The study and the proposed procedure were approved by the institutional review board committee of St. Johannes Hospital in Dortmund and was in compliance with the tenets of the Declaration of Helsinki.

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Informed consent was obtained from all individual participants included in this study.

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Habbe, K.J., Kohlhaas, M. & Fili, S. Complications after CyPass® Micro-Stent explantation: a case series. Int Ophthalmol 44, 45 (2024). https://doi.org/10.1007/s10792-024-02993-2

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  • DOI: https://doi.org/10.1007/s10792-024-02993-2

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