Imagining of intrascleral lake after implantation of ex-press mini shunt device in glaucoma surgery using visante optical coherence tomography
Autores: López-Caballero C , Sánchez-Sánchez C., Puerto-Hernández B., Contreras I., Blázquez-Sánchez V, Fernández P. Morán A.
Our purpose was to study the characteristics of the intrascleral lake after implantation of the Ex-Press shunt device using Visante anterior segment optical coherence tomography (AS-OCT).
Patients who had received an Ex-Press device at least three months prior to the study were evaluated. They were all treated with the insertion of the Ex-PRESS mini shunt model P50 under a 4×4-mm scleral flap. Mitomycin C 0.2 mg/mL for 1 min was applied under the conjunctiva after the formation of the scleral flap.
Longitudinal and transversal images of the intrascleral lake were acquired with AS-OCT. Time from surgery, visual acuity, intraocular pressure (IOP) and number of hypotensive drugs required were also recorded.
Five patients who had undergone isolated Ex-Press implantation and 6 patients combined cataract and Ex-Press device surgery were included. Mean time from the procedure was 23 months (range 3-38 months). Surgery resulted in a reduction of the number of hypotensive drugs to 55.3% ± 40.1%. The mean widest transversal width of the intrascleral lake was 4.5 ± 0.9mm and the mean widest longitudinal width 3.11 ± 0.74mm. We found no correlation between the longitudinal and transversal measures of the intrascleral lake and post-surgical IOP (Pearson factor -0,270 p=0.51 and -0,147 p=0.68 respectively). Neither was there a correlation between time from surgery and the characteristics of the intrascleral lake in our sample.
Although Ex-Press shunt implantation leads to the formation and preservation of an intrascleral and subconjuntivallake, we found no relation between its longitudinal and transversal width and postsurgical IOP. Larger studies would be necessary to determine if IOP is related to scleral lake characteristics after Ex-Press implantation.
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This work was not finantially supported.