en
Scientific article
Case report
English

EyeWatch rescue of refractory hypotony after Baerveldt drainage device implantation: description of a new technique

Published inJournal of Glaucoma, vol. 29, no. 2, p. e7-e10
Publication date2020
Abstract

The most effective way to control glaucoma is by lowering intraocular pressure (IOP) in order to prevent the progression of the disease. Glaucoma drainage devices (GDDs) are surgical option reserved for refractory cases and have been designed to address known complications of conventional filtering surgery. They are, however, associated with a higher rate of complications related to early hypotony and late corneal decompensation. In the case of the commonly used Baerveldt Glaucoma Implant (BGI), techniques exist in an attempt to prevent early postoperative hypotony but can be highly variable and surgeon dependent. Moreover, the additional steps required can result in unstable IOP in the immediate postoperative period. In 2014, Villamarin and colleagues described for the first time an adjustable GDD, called the eyeWatch implant, designed to better control IOP fluctuations and avoid hypotony during the early postoperative period via magnetic control of the device tube lumen. This innovation provides the possibility to adjust the amount of aqueous humor outflow after device implantation in a noninvasive manner. We report the case of an 83-year-old patient with advanced pseudoexfoliative glaucoma, referred to our tertiary center because of disease progression despite topical therapy and having undergone deep sclerectomy. First, a BGI was implanted but was unfortunately complicated by a 3-month chronic refractory hypotony from day 8, and choroidal detachment despite medical management, choroidal drainage, and viscoelastic injections. After 3 months, the decision was made to rescue the situation with an eyeWatch adjunction to the BGI. Postoperatively, the IOP was successfully controlled through fine adjustments of the eyeWatch opening position, until the last visit 8 months after the rescue, with complete resolution of the choroidal detachment and without any medications. This demonstrates that the eyeWatch may offer an answer not only to the immediate postoperative hypotonic phase of the GDD surgery but also to the later cystic bleb hypertonic phase.

Keywords
  • Aged
  • 80 and over
  • Choroid Diseases/physiopathology/surgery
  • Filtering Surgery
  • Glaucoma Drainage Implants
  • Humans
  • Intraocular Pressure/physiology
  • Male
  • Ocular Hypotension/physiopathology/surgery
  • Prosthesis Implantation
  • Retrospective Studies
  • Tonometry
  • Ocular
  • Treatment Outcome
  • Visual Acuity/physiology
  • glaucoma
  • Glaucoma surgery
  • BGI
  • Baerveldt glaucoma implant
  • GDD
  • Glaucoma drainage device
  • Chronic hypotony
  • Choroidal detachment
  • Revision
  • EyeWatch
Affiliation Not a UNIGE publication
Citation (ISO format)
ELAHI, Sina et al. EyeWatch rescue of refractory hypotony after Baerveldt drainage device implantation: description of a new technique. In: Journal of Glaucoma, 2020, vol. 29, n° 2, p. e7–e10. doi: 10.1097/IJG.0000000000001417
Main files (1)
Article (Published version)
accessLevelRestricted
Identifiers
ISSN of the journal1057-0829
315views
0downloads

Technical informations

Creation01/13/2021 3:40:00 PM
First validation01/13/2021 3:40:00 PM
Update time03/15/2023 11:52:43 PM
Status update03/15/2023 11:52:42 PM
Last indexation01/17/2024 12:11:10 PM
All rights reserved by Archive ouverte UNIGE and the University of GenevaunigeBlack