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Management of Persistent Hypotony after Supraciliary CyPass® Implantation Using Argon Laser.


ABSTRACT: Purpose:To report a case and management of persistent hypotony with hypotony-induced maculopathy after CyPass® device implant. Background:The CyPass® was the first supraciliary ab interno device approved by FDA and commercially available. Efficacy studies showed adequate intraocular pressure (IOP)-lowering results in combination with phacoemulsification. Hypotony induced by suprachoroidal minimally invasive glaucoma surgery (MIGS) was reported to be lower than 3% in the population that comprised the COMPASS study. Case description:A 57-year-old female patient with mild open-angle glaucoma with maximum topical medical therapy who underwent sequential bilateral CyPass® implantation developed persistent hypotony. Device obstruction was induced through argon laser burns directed to the peripheral iris, and the device was no longer visible on follow-up examinations. Topical IOP-lowering medication was restarted (timolol-dorzolamide) and has since been controlled under 16 mm Hg, without progression on visual fields. Conclusion:Argon laser burns directed to the peripheral iris to induce synechiae development that produces device obstruction are an effective technique to manage persistent hypotony after supraciliary CyPass® implantation. Clinical significance:Here, authors show a novel approach for treatment of persistent hypotony secondary to CyPass® implantation. In the knowledge of the authors, this is the first report that describes a noninvasive management for this complication, and this case could help other physicians to manage similar cases. How to cite this article:Fernando DV-N, Díez-Cattini GF, Alfonso G-L, et al. Management of Persistent Hypotony after Supraciliary CyPass® Implantation Using Argon Laser. J Curr Glaucoma Pract 2019;13(3):116-118.

SUBMITTER: Fernando DV 

PROVIDER: S-EPMC7221243 | BioStudies | 2019-01-01

SECONDARY ACCESSION(S): NCT02700984

REPOSITORIES: biostudies

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