TJ-CEO
2019 , Vol 14 , Num 2
Usage of Tissue Plasminogen Activator for Blood Clot in XEN Stent Lumen
1Uz. Dr., Sağlık Bilimleri Üniversitesi Şişli Hamidiye Etfal Eğitim ve Araştırma Hastanesi, Göz Hastalıkları, İstanbul, Türkiye2Asist. Dr., Sağlık Bilimleri Üniversitesi Şişli Hamidiye Etfal Eğitim ve Araştırma Hastanesi, Göz Hastalıkları, İstanbul, Türkiye
3Prof. Dr., Sağlık Bilimleri Üniversitesi Şişli Hamidiye Etfal Eğitim ve Araştırma Hastanesi, Göz Hastalıkları, İstanbul, Türkiye XEN 45 stent (Allergan, Dublin, CA) is a new minimally invasive glaucoma surgery (MIGS) method using the identical outfl ow pathway as trabeculectomy, but less conjunctival scarring. A 65-year-old female underwent XEN stent implantation surgery, due to uncontrolled intraocular pressure and visual field deterioration in the right eye despite medical treatment. Postoperative gonioscopy examination revealed a blood clot occluding the stent orifi ce. Intracameral injection of tissue plasminogen activator (tPA) was performed to dissolve the blood clot and to open the lumen. However, hyphema filling 2/3 of anterior chamber was developed on the first day following injection. During follow up, hyphema was rapidly reduced by diffusing to subconjunctival area via stent and completely disappeared on post-operative 10th day. Intracameral tPA is a useful option in breaking down the blood clot obstructing the XEN stent lumen but it should not be forgotten that anterior chamber hemorrhage may come out if it is applied in the early postoperative period. Keywords : Glaucoma, XEN gel stent, minimally invasive glaucoma surgery