XEN45 gel stent implant: comparison of 1 year results in primary open-angle glaucoma vs secondary open-angle glaucoma

Session Details

Session Title: Glaucoma & Posterior Segment

Session Date/Time: Monday 24/09/2018 | 08:00-10:30

Paper Time: 09:00

Venue: Room A3, Podium 1

First Author: : N.Moura-Coelho PORTUGAL

Co Author(s): :    E. Vares Luis   S. Crisostomo   A. Basilio   M. Dutra-Medeiros   M. Sa Cardoso   T. Gomes     

Abstract Details

Purpose:

To compare the efficacy and safety of the XEN45 Gel Stent Glaucoma Treatment System (Allergan, Irvine, CA) between patients with medically refractory primary open-angle glaucoma (POAG) and patients with secondary open-angle glaucoma (SOAG).

Setting:

The study was conducted at a Tertiary Centre for Ophthalmology in Portugal - Ophthalmology Department, Central Lisbon Hospital Centre - and reports the initial experience with XEN implantation nationwide.

Methods:

Retrospective comparative interventional case series of 19 eyes of 18 patients with medically refractory OAG (mrOAG) who underwent XEN implantation at our institution. Patients were grouped in 2 groups according to etiology (POAG, PG; SOAG; SG). Primary outcome was success at 12-month follow-up, defined as an intra-ocular pressure (IOP) reduction rate (IOP-RR) ≥ 20% from baseline and IOP ≤ 18 mmHg and > 5 mmHg, with (qualified success) or without (complete success) the need for IOP-lowering drugs, and without reoperation for glaucoma including needling. Secondary outcomes were IOP reduction, IOP-RR, reduction in number of IOP-lowering drugs, and complications.

Results:

At 12 months post-Xen implantation, significant IOP reduction occured in the PG (10.0 mmHg, p-value 0.006) on a lower median number of drugs (- 3.0; p-value 0.003), but not in the SG (- 2.0 mmHg; p-value 0.069). Median IOP reduction and IOP-RR were significantly higher in the PG compared with the SG (p-values 0.039 and 0.039, respectively). The absolute number of successful cases was higher and the number of cases requiring additional surgeries was lower in the PG. However, differences between patient groups for success and number of complications were not statistically significant (p-values 0.208 and 0.209, respectively).

Conclusions:

In our study, the XEN stent appears to have higher efficacy in IOP reduction in POAG when compared with SOAG. Larger, prospective studies are needed to confirm our results that etiology of glaucoma plays a role in XEN surgery outcomes and to ascertain whether secondary glaucoma might be associated with surgical complications.

Financial Disclosure:

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