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Long-term Success of Esnoper Clip Sclerectomy in Chronic Glaucoma

This is an 80-year-old woman with chronic open-angle glaucoma with poor pressure control despite maximum pharmacological treatment. On examination, pressures of 22 mmHg are found in both eyes with terminal glaucomatous optic nerve damage.

It was decided to perform Non-Penetrating Deep Sclerectomy with ­Esnoper Clip implant (AJL, Alava, Spain) in both eyes. After one year, diffuse well-vascularised blebs are present in both eyes (figure 1: right eye; figure 2: left eye). 

CASIA2 allows us to obtain images of the conjunctival bleb, visualising the presence of subconjunctival cystic spaces, the integrity of the intra-scleral lake, and posterior transscleral flow (figure 3, right eye, arrow), as well as visualising the presence of supraciliary filtration allowed by this implant.

In the left eye section, supraciliary flow can be visualised (figure 4, left eye, arrow). Pressures after one year were 8 mmHg in the right eye and 5 mmHg in the left eye.

Figure 1
Figure 1
Figure 2
Figure 2
Figure 3
Figure 3
Figure 4
Figure 4

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