Background: Trabeculectomy (TE) has been the standard procedure in glaucoma surgery for a long time. This study examined the efficacy and safety profile of XEN45 Gel Stent (XEN) after failed and/or scarred trabeculectomy.
Material And Methods: We analysed all files of patients, who received a XEN after insufficient TE and examined changes in intraocular pressure (IOP), IOP-lowering medication, best corrected visual acuity, visual field tests as well as the intra- and postoperative complications recorded within a 12-month follow-up period.
Results: 31 eyes of 28 patients were analysed in our study (mean age: 66,2 ± 13,4 years; 39% female; 48% right eye; mean follow-up after TE: 70,3 ± 64,9 months). The mean IOP decreased from 23,5 ± 6,5 to 18,0 ± 5,3 mmHg (- 23,5% compared to baseline-IOP; p = 0,01) while the mean IOP-lowering medication could be reduced from 2,8 ± 1,1 to 1,1 ± 1,5 (p < 0,01) 12 months after XEN-implantation. The mean visual acuity did not change significantly (pre-op: 0,5 ± 0,6 logMAR; 12 months post-op: 0,5 ± 0,6 logMAR). The most common complications postoperatively were choroideal detachment due to postoperative hypotony in 4 eyes (13%), a needling procedure in 9 eyes (29%), a Re-XEN-Implantation in 4 eyes (13%), an open revision of the conjunctiva in 3 eyes (10%), and a Re-TE in 1 eye (3%) as well as an Ahmed-Valve implantation in 2 eyes (6%). Overall, neither needling procedure nor further glaucoma surgery was necessary in 19 eyes (61%). In 10 of 22 evaluable eyes (45%) an IOP reduction of > 20% was achieved 12 months after XEN implantation.
Conclusion: XEN could be an effective method to reduce IOP after failed TE. The rate of complications seems to be low and the rate of needling procedures and/or revisions is acceptable.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1055/a-1553-4547 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Ab-Externo XEN Gel stent implantation effectively treated refractory glaucoma with prior failed shunt tube.
BMC Ophthalmol
August 2024
Department of Ophthalmology, Broward Health, Fort Lauderdale, FL, USA.
Purpose: To assess the efficacy of a gelatin stent (XEN 45 Gel Stent; Allergan) implant in advanced glaucoma eyes that have failed prior aqueous shunt implantation.
Methods: We retrospectively reviewed 6 patients with refractory glaucoma, defined as persistently high IOP (> 21 mmHg) despite taking at least 3 IOP-lowering medications subsequent to undergoing a glaucoma drainage device (GDD) with or without a second GDD or cilioablative procedure. Eyes with previous failed GDD underwent subconjunctival 0.
One year efficacy and safety of inferior implantation of Xen 45® Gel Stent in refractory glaucoma.
J Fr Ophtalmol
October 2024
Quinze-Vingts National Ophthalmology Hospital, Inserm-DHOS CIC 1423, IHU FOReSIGHT, 75012 Paris, France; Department of Ophthalmology III, Quinze-Vingts National Ophthalmology Hospital, IHU FOReSIGHT, 75012 Paris, France; Department of Ophthalmology, Ambroise-Paré Hospital, AP-HP, UVSQ, Paris Saclay University, 91190 Gif-sur-Yvette, France.
Purpose: The goal of this study was to assess the efficacy and safety of inferior implantation of the Xen Gel 45® Stent in a cohort of refractory glaucoma patients who had undergone multiple failed procedures and lacked healthy superior conjunctiva.
Patients And Methods: We retrospectively included individuals with refractory glaucoma who underwent implantation of a Xen 45® in the inferior quadrants of the conjunctiva. At the 12-month mark, two success criteria were assessed: "Complete" success, defined as an intraocular pressure (IOP)≤21mmHg with a≥20% reduction in IOP without additional IOP-lowering medications, the absence of a requirement for additional filtering surgery, and the absence of chronic hypotony; and "Qualified" success, which consisted of patients meeting the same criteria but requiring glaucoma medications postoperatively.
Two-Year Results of XEN Gel Stent Implantation for Pseudoexfoliative Glaucoma in Phakic versus Pseudophakic Eyes.
J Clin Med
July 2024
Centre for Ophthalmology, University Hospital Tuebingen, Elfriede-Aulhorn-Str. 7, 72076 Tübingen, Germany.
: To investigate whether phakia affects the outcome of XEN-45 gel stent implantation in the treatment of pseudoexfoliative glaucoma (PXG). : A retrospective, comparative cohort study of 30 phakic and 55 pseudophakic PXG patients who received the XEN-45 gel stent at a tertiary centre. The primary outcome measure was two-year success defined as a ≥20% lowering of intraocular pressure (IOP) and a target IOP of 6-21 mmHg.
View Article and Find Full Text PDFHistopathological findings of failed blebs after microinvasive bleb surgery with the XEN Gel Stent and Preserflo MicroShunt.
Graefes Arch Clin Exp Ophthalmol
September 2024
Department of Ophthalmology, University Eye Hospital, Eberhard Karls University, Elfriede-Aulhorn Str. 7, 72076, Tübingen, Germany.
Purpose: The success of XEN Gel Stent (XEN) and Preserflo MicroShunt (Preserflo) implantation depends mainly on the development of bleb fibrosis. This study aimed to describe the histological findings of bleb fibrosis after XEN and Preserflo surgery.
Methods: This retrospective study included patients with different types of glaucoma who underwent revision surgery after XEN or Preserflo implantation.
XEN-45 in the management of early glaucoma surgery: A national Delphi consensus study.
Arch Soc Esp Oftalmol (Engl Ed)
March 2024
Servicio de Oftalmología, Hospital Universitario Araba, Vitoria-Gasteiz, Spain; Departamento de Dermatología, Oftalmología y Otorrinolaringología, Universidad del País Vasco, Leioa, Spain.
Background And Objective: Recommendations on general glaucoma management and the use of early minimally invasive and microincisional surgeries are limited. This study aimed to establish consensus regarding glaucoma management, focusing on the XEN-45 gel stent implant.
Methods: A Delphi consensus-driven process was used.
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!