Abstract:
Purpose: To report the first case of Neodymium Yttrium Aluminum Garnet (Nd:YAG) laser use to recanalize a
CyPass occluded with a clot in the early postoperative follow-up.
Observations: A 66 year-old woman with primary open angle glaucoma and cataract received combined cataract
surgery plus CyPass in the right eye. Surgery was uneventful, however, there was a small amount of hyphema
related to bleeding around the site of Cypass insertion. Intraocular pressure (IOP) was between 6 and 7 mmHg in
the first week on no glaucoma medications. At the second postoperative week, IOP jumped to 30 mmHg and a
clot was observed obstructing the CyPass lumen. We disrupted the clot with a single shot from a Nd:YAG laser.
Twenty minutes after the laser, the IOP was 8 mmHg. CyPass was recanalized without complications. IOP was
11 mmHg at 1 month postoperatively with timolol 0.5% twice a day.
Conclusions and importance: It is important to perform gonioscopy to evaluate for CyPass obstruction in cases of
IOP spike. Nd:YAG laser may be a useful approach to recanalize the CyPass in the early postoperative follow-up
