Microsurgical trimming of the CyPass stent : Surgical procedure of the Neubrandenburg Eye Clinic. Video article

OBJECTIVE OF SURGERY: The indications for CyPass trimming are based on the standard protocol for endothelial protection of the Department of Ophthalmology at the Dietrich Bonhoeffer Hospital Neubrandenburg. The CyPass stent should be shortened to a maximum reach up to the scleral spur.

INDICATIONS: The indications for CyPass trimming are based on two main criteria: the position of the CyPass in relation to the structures of the anterior chamber angle and the presence of corneal endothelial cell loss.

CONTRAINDICATIONS: There are no contraindications.

SURGICAL TECHNIQUE: The operation shown in the video available online is performed with the patient under local anesthesia. The incisions are created individually and depend on the position of the CyPass stent. Through a 1.2 mm corneal paracentesis opposite to the stent, the anterior chamber is filled with a cohesive viscoelastic material and the stent is stabilized with a 20-gauge vitreous forceps and then cut with 20-gauge bent vitreous scissors through another 1.4-1.8 mm paracentesis, 3-4 h away from the stent visualized by gonioscopy. In some cases, surgical goniosynechiolysis in the area of the stent is required. The anterior end of the stent is cut as deep as possible. After aspiration of the viscoelastic material and possibly blood, the anterior chamber is toned with balanced salt solution (BSS) and the paracenteses are hydrated. Corneal suturing is not necessary.

RESULTS: Up to November 2019 65 CyPass stents in 64 eyes have been trimmed using this method. Iridodialysis occurred in 1 eye, in 12 eyes slight self-limiting bleeding and in 2 eyes an iris defect.

CONCLUSION: The procedure shown enables a safe microsurgical shortening of the CyPass stent with few complications. The risk of intraoperative expulsive bleeding or postoperative fistulation is markedly reduced.

Medienart:

E-Artikel

Erscheinungsjahr:

2020

Erschienen:

2020

Enthalten in:

Zur Gesamtaufnahme - volume:117

Enthalten in:

Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft - 117(2020), 12 vom: 06. Dez., Seite 1241-1246

Sprache:

Deutsch

Weiterer Titel:

Mikrochirurgische Kürzung des CyPass-Stents : Operationsverfahren der Neubrandenburger Augenklinik. Videobeitrag

Beteiligte Personen:

Medra, Ahmed [VerfasserIn]
Schwanengel, Mathias [VerfasserIn]
Weber, Annegret [VerfasserIn]
Brinkmann, Christian Karl [VerfasserIn]

Links:

Volltext

Themen:

Corneal endothelium
Journal Article
Local anesthesia
Microinvasive glaucoma surgery
Paracentesis
Review
Suprachoroidal stent trimming
Video-Audio Media

Anmerkungen:

Date Completed 04.12.2020

Date Revised 31.05.2022

published: Print

Citation Status MEDLINE

doi:

10.1007/s00347-020-01247-7

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM316336785