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Trabecular Micro-Bypass Stent Use in Necrotizing Scleritis.

Simrenjeet Sandhu¹, Lisa Heckler, Dean Mah

¹Department of Ophthalmology, University of Alberta, Edmonton, AB, Canada.

Journal of Glaucoma

|December 16, 2016

Summary

This case report details successful implantation of multiple trabecular micro-bypass iStents in a patient with necrotizing scleritis. The procedure effectively lowered intraocular pressure (IOP), offering a potential treatment for complex glaucoma cases.

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Area of Science:

Ophthalmology
Glaucoma Research
Surgical Innovation

Background:

Necrotizing scleritis can lead to significantly elevated intraocular pressure (IOP).
Steroid treatment for scleritis often exacerbates IOP, complicating glaucoma management.
Traditional glaucoma surgeries may be contraindicated or challenging in these patients.

Observation:

A 71-year-old male with primary open-angle glaucoma and necrotizing scleritis presented with severely elevated IOP.
The patient underwent successful implantation of multiple trabecular micro-bypass iStents in the affected eye.
The surgical procedure was uncomplicated.

Findings:

Post-surgery, IOP decreased from 42 mm Hg to 12 mm Hg at 18 months.
The patient required only two topical medications and daily oral prednisone (40 mg) for management.
Sustained IOP reduction was achieved with the iStent intervention.

Implications:

Trabecular micro-bypass iStents represent a viable option for IOP reduction in patients with necrotizing scleritis.
This surgical approach may circumvent challenges associated with traditional glaucoma surgeries in complex cases.
Further investigation into iStent efficacy for steroid-induced ocular hypertension secondary to scleritis is warranted.