Prominent lymphatic vessel in a functioning bleb after repeat XEN gel stent implantation surgery in pseudoexfoliative glaucoma: a case report

  • Hong-Kee Ng Lions Eye Institute, University of Western Australia, Nedlands, Western Australia, Australia
  • Paula Kun Yu Lions Eye Institute, University of Western Australia, Nedlands, Western Australia, Australia
  • Dao-Yi Yu Lions Eye Institute, University of Western Australia, Nedlands, Western Australia, Australia
  • William Huxley Morgan Lions Eye Institute, University of Western Australia, Nedlands, Western Australia, Australia
DOI: https://doi.org/10.35119/asjoo.v18i1.819
Keywords: bleb drainage, conjunctival lymphatics, glaucoma, pseudoexfoliation glaucoma, XEN surgery

Abstract

XEN gel stent implantation (XEN) surgery is becoming more popular due to its safety profile and efficacy, with conjunctival lymphatics thought to be critical in maintaining bleb drainage. We are reporting the case of a 75-year-old man with right eye pseudoexfoliative glaucoma who had two previous episodes of failed XEN surgery despite given needling and antimetabolite. He had a repeat XEN surgery in our center and his intraocular pressure was under control at the time of writing without any topical glaucoma medication, needling, nor antimetabolite. On examination, there was presence of prominent, dilated, and irregular lymphatic vessel originating from the distal end of the bleb. Anterior segment optical coherence tomography identified the lymphatic vessel located in the superficial Tenon’s layer, which is most likely an initial lymphatic but larger in diameter. This dilated lymphatic vessel may be an important factor for his currently successful filtration surgery.

References

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Khoo YJ, Abdullah AAH, Yu DY, Morgan WH. Use of trypan blue to assess lymphatic function following trabeculectomy. Clin Experiment Ophthalmol. 2019;47(7):892-897.

Welch J, Srinivasan S, Lyall D, Roberts F. Conjunctival Lymphangiectasia: A Report of 11 Cases and Review of Literature. Surv Ophthalmol. 2012; 57:136-148.

Published
2021-07-29
How to Cite
Ng, H.-K., Yu, P., Yu, D.-Y., & Morgan, W. (2021). Prominent lymphatic vessel in a functioning bleb after repeat XEN gel stent implantation surgery in pseudoexfoliative glaucoma: a case report. Asian Journal of Ophthalmology, 18(1), 92-97. https://doi.org/10.35119/asjoo.v18i1.819
Issue
Vol 18 No 1 (2021): Asian Journal of Ophthalmology
Section
Case Reports/Case Series

Copyright (c) 2021 Hong-Kee Ng, Paula Kun Yu, Dao-Yi Yu, William Huxley Morgan

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