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XEN-augmented Baerveldt Failure: Three Different Revision Approaches for Pediatric Patients
Patrícia José1, Luís Abegão Pinto2, Filipa Jorge Teixeira1
1Department of Ophthalmology, Centro Hospitalar Universitário Lisboa Norte, Hospital Santa Maria, Lisboa, Portugal; Ophthalmology University Clinic, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal.
Aim And Objective:
Report three different solutions in case of XEN-augmented Baerveldt fails.
Background:
Drainage devices have been used for refractory pediatric glaucoma. To avoid early hypotony and corneal damage, Mermoud et al. introduced the augmentation of a XEN implant with a Baerveldt tube. In some cases, this technique fails to lead to a high intraocular pressure (IOP) and surgical revision.
Case Description:
Three cases of children with this combined implant needed surgical revision due to high IOP. Three different approaches were performed: XEN replacement in one case, stretching the Baerveldt's tube into the anterior chamber (AC) in the second case, and explant of the device followed by an implant of a new Baerveldt-250 in the same quadrant in the third case. Successful control of IOP (>18 mm Hg) was achieved in all patients under no topical treatment.
Conclusion:
Despite the attractiveness of the XEN-augmented Baerveldt implant in refractory pediatric glaucoma as an alternative to conventional surgery, we have to learn how to deal with failures. Three different approaches are presented with good short-term results. The long-term efficacy is yet to be assessed.
Clinical Significance:
Describe three possible options when faced with a need for surgical revision in XEN-augmented Baerveldt implant.
How To Cite This Article:
José P, Abegão Pinto L, Teixeira FJ. XEN-augmented Baerveldt Failure: Three Different Revision Approaches for Pediatric Patients. J Curr Glaucoma Pract 2021;15(2):96-98.
