Purpose: The purpose of this study was to analyze the change in intraocular pressure (IOP) and glaucoma medications using the XEN Gel Stent as a solo procedure or in association with phacoemulsification in patients with chronic open angle glaucoma (OAG).
Methods: We included cohort studies with at least one year of follow-up in patients with primary open angle glaucoma (POAG), pseudo-exfoliative glaucoma (PXG) or pigmentary glaucoma (PG) who received a XEN gel stent. The main outcome measure was IOP reduction at 12 months follow-up. Secondary outcomes were the decrease in glaucoma medications 12 months after surgery, frequency and type of postoperative interventions and complication rate.
Results: A total of 8 case series published between 2016 and 2018 were included; six were prospective studies, and two were retrospective. There was no randomized controlled trial. The data concerned a total of 958 eyes of 777 patients. The various studies showed a mean IOP at 12 months between 13 and 16mmHg, which represented an IOP reduction between 25 and 56% (mean: 42%). This decrease was associated with a reduction in glaucoma medications in all studies. The decrease in IOP was significantly greater in XEN implantation as a stand-alone procedure (44%) than in combined surgery (32%) (P<0.05). Transient hypotony (< 1 month) (3%), choroidal detachment or choroidal folds (1.5%), hyphema (1.9%), bleb leak (1.1%) and shallow anterior chamber (1.1%) were the most frequent complications. As for severe complications, four cases of malignant glaucoma (0.4%) and one case of retinal detachment have been reported. In the follow-up period, needling has been required in 32% of cases, and a total of 55 eyes (5.7%) required repeat filtering surgery or cyclodestructive procedure.
Conclusion: XEN Gel Stent appears effective for reducing IOP and the number of medications in OAG patients within 1 year postoperatively with an acceptable safety profile. However, vigilant postoperative follow-up and frequent postoperative maneuvers are required.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.jfo.2018.12.002 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Assessing XEN microstent's one-year efficacy: independent of site variability.
Int J Ophthalmol
January 2025
Department of Ophthalmology, University of Leipzig, Liebigstrasse 10-14, Leipzig 04103, Germany.
Aim: To evaluate the short-term efficacy of XEN45 Gel Stent (XEN) implantation for primary open angle glaucoma (POAG) and pseudoexfoliation (PEX) glaucoma across two university eye clinics, aiming to assess the impact of varying center-specific protocols during the first postoperative year.
Methods: We retrospectively examined 282 patients (183 in center 1, 99 in center 2), who underwent XEN microstent implantation for uncontrolled POAG or PEX glaucoma. Parameters including intraocular pressure (IOP), IOP-lowering medication count, best corrected visual acuity (BCVA), and postoperative complications were evaluated over 12mo.
Macaroni necklace technique - Removal of a Xen gel stent.
Am J Ophthalmol Case Rep
December 2024
Casey Eye Institute at Oregon Health and Science University, 515 SW Campus Dr., Portland, OR, 97239, USA.
This video demonstrates the novel "macaroni necklace" technique for removing a Xen gel stent. The technique allows for complete removal of the stent without the hydrated and soft pieces from tearing apart. In this case, the stent was the nidus for endophthalmitis, and complete removal is necessary for prevention of future infections.
View Article and Find Full Text PDFClinical outcomes of Xen 45 gel stent implantation(Ab externo, open conjunctival approach) versus Trabeculectomy: A real world study.
Korean J Ophthalmol
December 2024
Department of Ophthalmology, Institute of Vision Research, Severance Eye Hospital, Yonsei University College of Medicine, South Korea.
Article Synopsis
- The study compared clinical outcomes of Xen 45 gel stent surgery and trabeculectomy in glaucoma patients, analyzing data from 62 eyes treated with Xen and 78 eyes with trabeculectomy over specific periods.
- Results showed a lower complete success rate for Xen (33.9%) compared to trabeculectomy (57.7%), along with higher postoperative intraocular pressure and more glaucoma medications needed in the Xen group; however, it had fewer complications (0% vs. 16.7%) and shorter operation time.
- Both surgical methods yielded similar postoperative best corrected visual acuity but differed in success rates, medication requirements, and safety profiles, indicating that while Xen may be quicker and safer
Transconjunctival XEN® 45 Gel Stent Implantation: Efficacy and Safety of a New Surgical Technique.
J Curr Glaucoma Pract
October 2024
Department of Ophthalmology, Hospital of San Severino Marche, AV3- Asur Marche, Macerata, Italy.
Article Synopsis
- This study aimed to assess the effectiveness and safety of a new surgical method called transconjunctival XEN® 45 gel stent implantation in treating primary open-angle glaucoma (POAG).
- A total of 31 patients underwent the procedure, experiencing an average decrease in intraocular pressure from 25.3 mm Hg pre-surgery to 15.9 mm Hg post-surgery, with most not needing additional medications by the one-month follow-up.
- The results suggest that this surgical technique is both safe and effective, offering a timely alternative for patients with POAG needing surgical intervention earlier in their treatment process.
Three-Year Results of XEN-45 Implantation for Glaucoma Secondary to Fuchs Uveitis Syndrome, Intermediate Uveitis, and Juvenile Idiopathic Arthritis-Related Anterior Uveitis.
Ocul Immunol Inflamm
November 2024
Centre for Ophthalmology, University Hospital Tuebingen, Tuebingen, Germany.
Purpose: To investigate the long-term outcomes of XEN-45 implantation for glaucoma secondary to Fuchs uveitis syndrome (FUS), juvenile idiopathic arthritis (JIA)-related anterior uveitis and intermediate uveitis (IU).
Methods: This retrospective study evaluated 19 eyes with FUS, 10 eyes with JIA, and nine eyes with IU that underwent XEN-45 Gel Stent implantation. The primary outcome measure was 3-year surgical success, defined as a ≥20% reduction in intraocular pressure (IOP), with a target IOP of 6-21 mmHg.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!