Cannizzo, Paola Maria Loredana

Consolandi, Giulia

Fea, Antonio Maria

Gallozzi, Francesco

Grignolo, Federico

Lavia, Carlo Alessandro

Pignata, Giulia

Rolle, Teresa

Spinetta, Roberta

English

Cannizzo, PAOLA MARIA LOREDANA

Institutional Research Information System University of Turin

FREEARVO Annual Meeting Abstract  |   April 2014Anterior segment OCT and confocal microscopy can bepredictive of the bleb failure of a new minimallyinvasive glaucoma surgery technique, the XEN implant(Aquesys)?Giulia Consolandi; Antonio Maria Fea; Carlo Alessandro Lavia; Giulia Pignata; Paola Maria Loredana Cannizzo; Francesco Gallozzi;Roberta Spinetta; Teresa Rolle; Federico M Grignolo  Author Affiliations & NotesInvestigative Ophthalmology & Visual Science April 2014, Vol.55, 942. doi:AbstractPurposeMost of the minimally invasive glaucoma surgery (MIGS) procedures address the angle or the suprachoroidal space bythe use of new implants (Glaukos, Ivantis, Transcend, MidiArrow) but their proper placement and the patency of theoutflow pathways remains a matter of clinical experience. Aim of the study was to investigate if anterior segment OCT andconfocal microscopy could add clinical informations of the long term health of the bleb obtained using a new collagenderived implant (XEN).MethodsThe device was implanted in 10 POAG patients (8 males/ 2 females, 64,5 mean age ±12,93 SD). IOP with GAT, AS-OCT(RTVue, Optovue), confocal microscopy (Heidelberg) were assessed one day, 1 week, 1 month and 6 monthspost-operatively. At the same time points, bleb morphology was evaluated by two masked observers. The bleb wasdefined as present, encapsulated, cystic or absent. The position and the presence of fluid were evaluated using theAS-OCT. The presence of subconjunctival cystic spaces was assessed by the confocal microscopy. Complete success wasdefined as mean diurnal IOP<18 mm Hg and qualified success as mean diurnal IOP<18 mm Hg on medication.ResultsDirect communication between the anterior chamber and the subconjunctival space was demonstrated in all patientsintraoperatively by obtaining a bleb after intracameral injection of BSS. Mean IOP 1 day post-operatively was 14 mmHg(17 mmHg less than pre-operatively medicated IOP). The bleb was defined as present in all patients at 1 month by bothobservers. The track of the implant could be visualized using the AS-OCT . Subconjunctival fluid on OCT (fig.1) and cysticspaces on confocal microscopy could be demonstrated in 8 and 4 patients respectively at 1 month (fig.2). The 6 patients inwhich there was no evidence of subconjunctival cystic spaces at one month (fig 5), failed at 6 months.ConclusionsThis new MIGS implant present the advantage of allowing direct intraoperative assessment of the outflow from theanterior chamber to the subconjunctival space. AS OCT can be used in the immediate post-operative period to determinethe correct position of the implant and the presence of subconjunctival fluid. The presence of conjunctival cysts assessedby confocal microscopy seems a predictive factor of medium term failure of the bleb.Image Not AvailableView Original  Download Slide         Anterior segment OCT and confocal microscopy can be predictive of the... http://iovs.arvojournals.org/article.aspx?articleid=2272472&resultClick=11 di 2 27/06/2016 16:24Fig. 1.Image Not AvailableView Original  Download SlideFig. 2. Keywords: 568 intraocular pressure • 550 imaging/image analysis: clinical • 596 microscopy: confocal/tunneling  © 2014, The Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Permission to republishany abstract or part of an abstract in any form must be obtained in writing from the ARVO Office prior to publication.Anterior segment OCT and confocal microscopy can be predictive of the... http://iovs.arvojournals.org/article.aspx?articleid=2272472&resultClick=12 di 2 27/06/2016 16:24

Anterior segment OCT and confocal microscopy can be predictive of the bleb failure of a new minimally invasive glaucoma surgery technique, the XEN implant (Aquesys)?

https://iris.unito.it/bitstream/2318/157126/1/Anterior%20segment%20OCT%20and%20confocal%20microscopy%20can%20be%20predictive%20of%20the%20bleb%20failure%20of%20a%20new%20minimally%20invasive%20glaucoma%20surgery%20technique%2c%20the%20XEN%20implant%20%28Aquesys%29_.pdf

Anterior segment OCT and confocal microscopy can be predictive of the bleb failure of a new minimally invasive glaucoma surgery technique, the XEN implant (Aquesys)?

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