Two clinical cases with explantation and reposition of Express- implant

Abstract

Introduction: In the surgical treatment of glaucoma Express- implant is widely used recently. Rarely observed late postoperative complication is deterioration of filtration. Objective: We present two clinical cases of explantation and reposition of Express - implant. Clinical cases: R.H. - 42 years old, female, with advanced pigmentary glaucoma. In 2013 filtering surgery with Express implant on the left еуе was performed, and in March 2014 - filtering operation with Express implant and Ologen on the right еуе elsewhere. Six months later we measured intraocular pressure of the right еуе up to 38,0 mmHg. We performed revision and found scarring of the scleral flap. The same implant was placed under a new flap. D. B.- 80 years old, female. In 2008 the patient was diagnosed with advanced exfoliative glaucoma in both eyes. Urgent trabeculectomy of the right eye was performed and a maximal medical therapy for the left eye was prescribed. In 2011 a central retinal vein thrombosis of the left eye and intraocular pressure 38,0 mmHg was found and a filtering operation with Express implant was performed. During follow-up in 2015 a bleb scarring of the left eye and intraocular pressure 38,0 mmHg was found. A revision with explantation of the occluded Express shunt was performed. A standard trabeculectomy with Mitomycin C in a close location was done. Conclusion: Treatment of glaucoma by applying Express- implant is a modem method with a number of advantages, but likewise any surgery in rare cases early or late complications may occur.