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Recommendations for the management of elevated intraocular pressure due to bleb fibrosis after XEN gel stent implantation
Authors Vera V, Sheybani A, Lindfield D, Stalmans I, Ahmed IIK
Received 21 November 2018
Accepted for publication 11 February 2019
Published 18 April 2019 Volume 2019:13 Pages 685—694
DOI https://doi.org/10.2147/OPTH.S195457
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 2
Editor who approved publication: Dr Scott Fraser
Video 5 Bleb revision by Iqbal Ike K Ahmed.
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Vanessa Vera,1 Arsham Sheybani,2 Dan Lindfield,3 Ingeborg Stalmans,4 Iqbal Ike K Ahmed5
1Department of Glaucoma, Unidad Oftalmologica de Caracas, Caracas, Venezuela; 2Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St Louis, MO, USA; 3Department of Ophthalmology, Royal Surrey County Hospital, Guildford, Surrey, UK; 4Glaucoma Unit, University Hospitals UZ Leuven, Leuven, Belgium; 5Glaucoma and Advanced Anterior Segment Surgery, University of Toronto, Toronto, ON, Canada
Abstract: Surgical management of glaucoma offers a means of effective disease control. A gel stent that facilitates drainage to the subconjunctival space offers intraocular pressure (IOP) reduction similar to traditional glaucoma filtering surgeries in a less invasive manner. However, like all subconjunctival filtering procedures that result in a bleb, fibrosis can present as a cause of elevated IOP. The following proposed techniques and recommendations for managing elevated IOP due to bleb fibrosis after gel stent implantation are based on the clinical experience of the authors. The goal of this paper is to improve outcomes following gel stent surgery by providing guidance on assessment of bleb function and strategies for bleb enhancement.
Keywords: glaucoma gel stent, bleb management, bleb fibrosis, glaucoma surgery, glaucoma filtering surgery, bleb needling
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