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Combined microinvasive glaucoma surgery in osteogenesis imperfecta patient with refractory open angle glaucoma
Daniel Laroche1,2, Gideon Nkrumah3,2
1New York Eye and Ear Infirmary, Icahn School of Medicine of Mount Sinai, 10003, USA.
American Journal of Ophthalmology Case Reports
|February 22, 2020
Summary
This study presents a novel surgical approach for refractory open-angle glaucoma (POAG) in patients with osteogenesis imperfecta (OI). Combination microinvasive glaucoma surgery effectively lowered intraocular pressure, offering a bleb-sparing alternative.
Area of Science:
- Ophthalmology
- Glaucoma Surgery
- Genetics and Rare Diseases
Background:
- Osteogenesis imperfecta (OI) presents unique challenges in glaucoma management due to scleral and conjunctival thinning.
- Refractory open-angle glaucoma (POAG) requires innovative surgical solutions in patients with connective tissue disorders.
Observation:
- A 57-year-old female with osteogenesis imperfecta and uncontrolled POAG underwent combined Kahook blade goniotomy and ciliary sulcus suprachoroidal microtube insertion.
- Pre-operative intraocular pressure (IOP) was 26 mmHg on six medications, with significant glaucomatous optic nerve damage.
Findings:
- The combined microinvasive glaucoma surgery successfully reduced IOP to 13 mmHg at 6 months post-operation.
- Medication burden decreased from six to three agents, indicating improved IOP control.
Implications:
- This bleb-sparing surgical technique offers a viable alternative for managing POAG in OI patients, circumventing challenges associated with traditional glaucoma surgeries.
- Enhanced aqueous outflow through the supraciliary space and aqueous veins provides sustained IOP reduction.
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