Unexpected visual acuity loss as the first sign of a xen implant complication

Abstract

AbstractPurposeMinimally invasive glaucoma surgery (MIGS) using diferent devices is a promising strategy for treating mild glaucoma. However, long‐term complications require further evaluation. We report a case of displacement to the anterior chamber and cornea of a previously successful XEN implant.MethodsA 85‐year‐old female treated for open angle glaucoma with Latanoprost, Timolol and Brinzolamide started presenting IOP of 24 mmHg in her right eye and a progression was also evident in visual field examination and spectral‐domain optical coherence tomography. Due to failure of medical treatment, surgery with a XEN implant was offered to the patient. The XEN implant was successfully implanted in the right eye and an adecuate control of the IOP was achieved for eight months. After that period of time, IOP raised to 22 mmHg and topical treatment with Brinzolamide and Timolol was reintroduced. Nine months later, the patient suffered a visual acuity loss and came to the emergency department. During the slit‐lamp examination intense corneal edema, Descement membrane folds and a dislocation of the XEN implant into the anterior chamber affecting the cornea were described.ResultsTaking into account the patient situation we started adding topical corticosteroid therapy to her previous treatment. Finally a surgical removal of the implant was performed. Rejecting other surgical therapies for now, the patient is at the moment treated topically.ConclusionsDespite MIGS is a safe and useful technique, long‐term complications require further evaluation. We describe the dislocation of a XEN implant into the anterior chamber or to the cornea as a new potential complication of this device to keep in mind.