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Amina Rezkallah, Thibaud Mathis, Philippe Denis, Laurent Kodjikian; XEN Gel Stent to Treat Intraocular Hypertension After Dexamethasone-Implant Intravitreal Injections: 5 Cases. Invest. Ophthalmol. Vis. Sci. 2019;60(9):3736. doi: https://doi.org/.
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Intravitreal injections (IVI) of slow-release dexamethasone (DEX) are generally well tolerated. Ocular hypertension (OHT) and cataracts are the most common adverse effects of DEX-implant (DEX-I). The cases reported concern 5 eyes in four DEX-I IVI high-responder patients whose intraocular pressure (IOP) returned to normal after administration of a XEN gel stent with mitomycin subconjunctival injection
We reported the cases of 5 eyes in four DEX-I IVI high-responder patients whose intraocular pressure (IOP) returned to normal after administration of a XEN gel stent with mitomycin subconjunctival injection, thus allowing the continued use of DEX-I which was the only therapeutic option for these patients. All patients were pure steroid responders with normal optic nerves.
No hypertension was observed in any of the eyes after DEX-implant intravitreal reinjection following XEN-surgery. All patients were successfully treated with XEN surgery and were retreated with DEX-implant with no further increase in IOP. The mean duration of follow-up after the MIGS procedure was 5 months (min-max, 2-12). None of the patients required needling.
XEN gel stent would seem to represent a safe and effective solution for treating steroid-induced hypertension. It allows for the medium and long-term use of DEX-I in high responders. It could be of clinical interest to study this combination in a prospective trial with a large number of patients and long-term follow-up.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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