A case of mitomycin C toxicity after XEN gel stent implantation with the XEN air technique in a glaucoma patient

BMC Ophthalmology

Case Report

Joon Young Baeg¹  Si Hyung Lee¹  Han Sol Choi¹ 

[1] Department of Ophthalmology, College of Medicine, Soonchunhyang University, Cheonan, Republic of Korea;Department of Ophthalmology, Soonchunhyang University Hospital Bucheon, Bucheon, Republic of Korea;

关键词: Postsurgical complication;    Uveitic glaucoma;    XEN gel stent;   

DOI  :  10.1186/s12886-023-03152-4

 received in 2023-05-03, accepted in 2023-09-23,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundTo discuss the first case of mitomycin C (MMC) toxicity after XEN® gel stent implantation in a glaucoma patient, conducted using the XEN “air” technique with an ophthalmic viscosurgical device (OVD).Case presentationA 44-year-old Asian male presented with increased intraocular pressure (IOP; 52 mmHg) accompanied by keratic precipitates and an edematous cornea. He was diagnosed with uveitic glaucoma in the left eye, and the IOP was controlled with a topical anti-glaucoma agent. However, glaucoma progression was revealed by Humphrey visual field (HVF) and optical coherence tomography (OCT) examinations. The patient underwent uneventful XEN gel stent implantation using the XEN air technique and an MMC (0.02%, 0.1 mL) injection, with subconjunctival air and OVD injection provided prior to XEN implantation in the left eye. The patient exhibited a decreased IOP (11 mmHg), elevated bleb, and extensive subconjunctival hemorrhage on postoperative day 1. On postoperative day 18, diffuse conjunctival injection and a large avascular bleb was noticed around the XEN gel stent. The patient complained of severe eye pain and discomfort, suggestive of MMC toxicity, and the IOP was 12 mmHg. The patient was treated with a topical steroid and antibiotics tapered over a 6-month period. Finally, the toxicity was successfully controlled, with the IOP stabilizing at around 15 mmHg.ConclusionsAlthough significantly greater lowering of the IOP can be expected with the use of subconjunctival OVD injection and MMC during XEN gel stent implantation, a cautious approach and a longer monitoring period are required.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

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