Ex-PRESS shunt combined with ab-interno peripheral iridectomy: A new surgical procedure for iridocorneal endothelial syndrome
Purpose: Iridocorneal endothelial (ICE) syndrome may cause refractory glaucoma due to progressive synechial closure or membrane formation at the anterior chamber angle. Filtration surgeries are often required but are associated with a higher rate of surgical failure or complications than other types...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-12-01
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| Series: | American Journal of Ophthalmology Case Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2451993623000956 |
| _version_ | 1827591559567114240 |
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| author | Ryotaro Wajima Tomomi Higashide Kazuhisa Sugiyama |
| author_facet | Ryotaro Wajima Tomomi Higashide Kazuhisa Sugiyama |
| author_sort | Ryotaro Wajima |
| collection | DOAJ |
| description | Purpose: Iridocorneal endothelial (ICE) syndrome may cause refractory glaucoma due to progressive synechial closure or membrane formation at the anterior chamber angle. Filtration surgeries are often required but are associated with a higher rate of surgical failure or complications than other types of glaucoma. Herein, we report a new and effective surgical procedure for glaucoma secondary to ICE syndrome: Ex-PRESS shunt combined with ab-interno peripheral iridectomy using a small-gauge vitreous cutter. Methods: Three patients with ICE syndrome who underwent surgery were included. Intraoperatively, an ab-interno peripheral iridectomy was performed using a small-gauge vitreous cutter through a corneal incision in the superior-nasal or superior-temporal quadrants to create space for the insertion of Ex-PRESS shunt free from the iris tissue. The shunt was inserted under the scleral flap. The first patient underwent combined cataract surgery, whereas patients 2 (pseudophakia) and 3 (phakia) underwent Ex-PRESS alone. Results: No intraoperative complications were observed. The intraocular pressure remained stable until the final postoperative visits at approximately 7, 4, and 1 year in Cases 1, 2, and 3, respectively. Case 2, with mild preoperative corneal edema due to graft failure in Descemet's stripping automated endothelial keratoplasty (DSAEK), underwent reDSAEK 6 months postoperatively. Conclusions and importance: Ex-PRESS shunt combined with ab-interno peripheral iridectomy using a small-gauge vitreous cutter may be a safe and effective surgical procedure in patients with ICE syndrome, regardless of the lens status. |
| first_indexed | 2024-03-09T01:34:28Z |
| format | Article |
| id | doaj.art-aab27942a1824e189bb5344bcbd6b28f |
| institution | Directory Open Access Journal |
| issn | 2451-9936 |
| language | English |
| last_indexed | 2024-03-09T01:34:28Z |
| publishDate | 2023-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | American Journal of Ophthalmology Case Reports |
| spelling | doaj.art-aab27942a1824e189bb5344bcbd6b28f2023-12-09T06:07:08ZengElsevierAmerican Journal of Ophthalmology Case Reports2451-99362023-12-0132101887Ex-PRESS shunt combined with ab-interno peripheral iridectomy: A new surgical procedure for iridocorneal endothelial syndromeRyotaro Wajima0Tomomi Higashide1Kazuhisa Sugiyama2Department of Ophthalmology, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Ishikawa, 920-8641, JapanCorresponding author. Department of Ophthalmology, Kanazawa University Graduate School of Medical Sciences, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan.; Department of Ophthalmology, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Ishikawa, 920-8641, JapanDepartment of Ophthalmology, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Ishikawa, 920-8641, JapanPurpose: Iridocorneal endothelial (ICE) syndrome may cause refractory glaucoma due to progressive synechial closure or membrane formation at the anterior chamber angle. Filtration surgeries are often required but are associated with a higher rate of surgical failure or complications than other types of glaucoma. Herein, we report a new and effective surgical procedure for glaucoma secondary to ICE syndrome: Ex-PRESS shunt combined with ab-interno peripheral iridectomy using a small-gauge vitreous cutter. Methods: Three patients with ICE syndrome who underwent surgery were included. Intraoperatively, an ab-interno peripheral iridectomy was performed using a small-gauge vitreous cutter through a corneal incision in the superior-nasal or superior-temporal quadrants to create space for the insertion of Ex-PRESS shunt free from the iris tissue. The shunt was inserted under the scleral flap. The first patient underwent combined cataract surgery, whereas patients 2 (pseudophakia) and 3 (phakia) underwent Ex-PRESS alone. Results: No intraoperative complications were observed. The intraocular pressure remained stable until the final postoperative visits at approximately 7, 4, and 1 year in Cases 1, 2, and 3, respectively. Case 2, with mild preoperative corneal edema due to graft failure in Descemet's stripping automated endothelial keratoplasty (DSAEK), underwent reDSAEK 6 months postoperatively. Conclusions and importance: Ex-PRESS shunt combined with ab-interno peripheral iridectomy using a small-gauge vitreous cutter may be a safe and effective surgical procedure in patients with ICE syndrome, regardless of the lens status.http://www.sciencedirect.com/science/article/pii/S2451993623000956Ex-PRESS shuntGlaucoma filtration surgeryIridocorneal endothelial syndromeIridectomyVitreous cutter |
| spellingShingle | Ryotaro Wajima Tomomi Higashide Kazuhisa Sugiyama Ex-PRESS shunt combined with ab-interno peripheral iridectomy: A new surgical procedure for iridocorneal endothelial syndrome American Journal of Ophthalmology Case Reports Ex-PRESS shunt Glaucoma filtration surgery Iridocorneal endothelial syndrome Iridectomy Vitreous cutter |
| title | Ex-PRESS shunt combined with ab-interno peripheral iridectomy: A new surgical procedure for iridocorneal endothelial syndrome |
| title_full | Ex-PRESS shunt combined with ab-interno peripheral iridectomy: A new surgical procedure for iridocorneal endothelial syndrome |
| title_fullStr | Ex-PRESS shunt combined with ab-interno peripheral iridectomy: A new surgical procedure for iridocorneal endothelial syndrome |
| title_full_unstemmed | Ex-PRESS shunt combined with ab-interno peripheral iridectomy: A new surgical procedure for iridocorneal endothelial syndrome |
| title_short | Ex-PRESS shunt combined with ab-interno peripheral iridectomy: A new surgical procedure for iridocorneal endothelial syndrome |
| title_sort | ex press shunt combined with ab interno peripheral iridectomy a new surgical procedure for iridocorneal endothelial syndrome |
| topic | Ex-PRESS shunt Glaucoma filtration surgery Iridocorneal endothelial syndrome Iridectomy Vitreous cutter |
| url | http://www.sciencedirect.com/science/article/pii/S2451993623000956 |
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