July 2019
Volume 60, Issue 9
Free
ARVO Annual Meeting Abstract  |   July 2019
Intraocular pressure reduction after Esnoper Clip Implantation during deep sklerectomy in 20 glaucoma patients
Author Affiliations & Notes
  • Stephanie Valerie Weissleder
    University of Hamburg, Hamburg, Germany
  • Maren Klemm
    University of Hamburg, Hamburg, Germany
  • Footnotes
    Commercial Relationships   Stephanie Weissleder, AJL Ophthalmics (F); Maren Klemm, AJL Ophthalmics (F)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 6655. doi:
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      Stephanie Valerie Weissleder, Maren Klemm; Intraocular pressure reduction after Esnoper Clip Implantation during deep sklerectomy in 20 glaucoma patients. Invest. Ophthalmol. Vis. Sci. 2019;60(9):6655.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : The Esnoper Clip is a new, non absorbable uveoscleral implant. It can be implanted while performing deep sklerectomy. We use the intraocular pressure (iop) and the use of anitglaucomatous eyedrops to determine the success.

Methods : 20 Patients (age 53 – 81) with open angle glaucoma and uncontrolled iop scheduled for deep sclerectomy were selected and received the Esnoper Clip during otherwise routine surgery. The clip was implanted in a total of 20 eyes. The device is foldable at its middle and attached through placing the lower part inside a small surgically formed subuveal pocket behind the schlemms-canal, while the upper part is fixated intrasclerally. Routine visits were scheduled after 3 and 6 months.

Results : After 3 Months there was a significant decrease in mean IOP from 20,4 ± 4,5 mmHg to 16,1 ± 3,7 mmHg (P= 0,02). And after 6 months the mean IOP was measured at 13,86 ± 3,616 (P= 0,01). The use of topical glaucoma eyedrops decreased from 2,9 ± 0,4 to 0,8 ± 1,0 (p= 0,01) after 3 months and stabilized at 1 ± 1,2 (p= 0,49) after 6 months. There were no intraoperative complications during the surgery. During the follow-up exams 4 eyes (20%) showed a corneal leakage (Positive Seidel-Testing) within 24h after surgery and in 1 case (5%) the implant dislocated and penetrated into the anterior chamber requiring further surgical intervention. A total of 11 patients (55%) had to undergo YAG-laserkoagulation to reopen the descemet-window.

Conclusions : The implantation of the Esnoper clip as a permanent implant is an alternative, compared to the commonly used spacers like e.g. Ologen. However the long term IOP-lowering effect and possible long term side effects have yet to be evaluated and are currently under investigation at our site. We expect to complete the 12 month follow-up in all 20 cases this winter.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

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