Abstract
This chapter describes a minimally invasive ab-interno approach to glaucoma filtration surgery. Glaucoma filtration surgery lowers intraocular pressure (IOP) by creating an alternative pathway to allow aqueous humor to drain out of the eye. Ab-externo trabeculectomy, with and without antimetabolite, and glaucoma drainage devices have been a long-term solution and a cornerstone in advanced glaucoma management after medications and laser trabeculoplasty have failed. The conventional ab-externo approach, despite all the innovations and surgical technique modifications, is still associated with short- and long-term complications. This chapter describes an innovative permanent ab-interno collagen implant (XEN Gel Stent, Aquesys, Inc.) that allows aqueous drainage into subconjunctival space. This chapter will address the characteristics of the implant procedure and available clinical data on efficacy, safety, and long-term outcomes. The novel ab-interno placement of this subconjunctival drainage device offers a minimally invasive alternative and decreases trauma to surrounding tissues.
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References
The Advanced Glaucoma Intervention Study Investigators. The Advanced Glaucoma Intervention Study (AGIS). 4. Comparison of treatment outcomes within race. Seven-year results. Ophthalmology. 1998;105:1146–64.
Watson PG, Jakeman C, Ozturk M, Barnett MF, Barnett F, Khaw KT. Complications of trabeculectomy (a 20-year follow-up). Eye. 1990;4:425–38.
Nouri-Mahdavi K, Brigatti L, Weitzman M, Caprioli J. Outcomes of trabeculectomy for primary open-angle glaucoma. Ophthalmology. 1995;102:1760–9.
Ticho U, Ophir A. Late complications after glaucoma filtering surgery with adjunctive 5-fluorouracil. Am J Ophthalmol. 1993;115:506–10.
Costa VP, Wilson RP, Moster M, Schmidt CM, Gandham S. Hypotony maculopathy following the use of topical mitomycin C in glaucoma filtration surgery. Ophthalmic Surg. 1993;24:389–94.
Dao-Yi Y, et al. The critical role of the conjunctiva in glaucoma filtration surgery. Prog Retin Eye Res. 2009;28:303–28.
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Alena Reznik and Rohit Varma declare that they have no conflict of interest.
No human or animal studies were carried out by the authors for this chapter.
Conflicts of Interest: Alena Reznik and Rohit Varma declare that they have no conflict of interest.
Animal Studies: No human or animal studies were performed by the authors of this chapter.
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6.1 Electronic supplementary material
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Video 6.1
Xen Gel implantation; Courtesy of Iqbal Ike K. Ahmed MD, FRCS (MOV 9345 kb)
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Reznik, A., Varma, R. (2015). Ab-Interno Subconjunctival Glaucoma Implant for Advanced Open-Angle Glaucomas. In: Aref, A., Varma, R. (eds) Advanced Glaucoma Surgery. Essentials in Ophthalmology. Springer, Cham. https://doi.org/10.1007/978-3-319-18060-1_6
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DOI: https://doi.org/10.1007/978-3-319-18060-1_6
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-18059-5
Online ISBN: 978-3-319-18060-1
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