Delayed bilateral hypertensive crisis with CyPass Micro-stent – The highs and lows

PURPOSE: Microinvasive glaucoma surgery and its associated devices remain a field of continued interest and innovation in the management of patients with glaucoma. While a range of outflow optimisation devices have been designed, the efficacy and safety and these devices remains to be proven, particularly in the long term. OBSERVATIONS: The authors present the first reported case to our knowledge of bilateral hypertensive crisis associated with CyPass® Micro-stent insertion two months post-operation and its resultant management. CONCLUSIONS AND IMPORTANCE: Despite the recall of the CyPass Micro-stent (Alcon, Fort Worth, Texas, USA), further clinical experience in the use of these and similar stents is required. Possible hypotheses explaining this phenomenon are also presented, the most likely being sudden closure of the suprachoroidal space.