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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)
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.
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.
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.
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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