Posters

Visual acuity change after minimally invasive transscleral glaucoma gel microstent implanation with adjunctive mitomycin C

Poster Details

First Author: M.Lenzhofer AUSTRIA

Co Author(s):    C. Strohmaier   M. Hohensinn   M. Gerner   V. Steiner   K. Motloch   H. Reitsamer     

Abstract Details

Purpose:

New minimally invasive surgical techniques have been implemented in glaucoma therapy in the last years. However, safety data is rare on these new methods. We know from literature, that the risk for a significant and permanent decrease in vision after classic filtering glaucoma surgery is high. 1 year after trabeculectomy, 32% of the patients experience a decrease of best-corrected visual acuity (BCVA, ≥2 lines). The present study therefore aims to assess changes in BCVA after XEN Glaucoma Gel Microstent (XEN-GGM, Allergan Plc., USA) implantation.

Setting:

Prospective non-randomized monocentric study at Paracelsus Medical University Hospital Salzburg (Austria).

Methods:

In this study, 172 eyes with open angle glaucoma received one XEN-GGM. 85 eyes were XEN-solo-procedures, 87 eyes combined procedures with cataract operation. BCVA was collected at baseline, day 1, after 1 and 2 weeks, 1, 3, 6, 9, 12, 18, and 24 months postoperatively (Snellen chart, logMAR scale). Risk factors for a decrease of BCVA postoperatively were calculated.

Results:

In the XEN-solo group the BCVA was 0.20±0.30 preoperatively and decreased the first postoperative day significantly to 0.33±0.28(p=0.029) while stabilizing after 1 week at preoperative levels(0.24±0.33). In the combined group no significant change of BCVA was detected at day 1 or week 1 compared to baseline (preoperative:0.32±0.30; day 1:0.40±0.55 [p=0.085]; week 1:0.29±0.26). After 1 week the BCVA was stable at baseline levels in the XEN-solo group at all postoperative visits, while in the combined group the BCVA significantly increased at 3(0.21±0.27,p=0.003), 6 (0.19±0.24,p=0.002), 12(0.18±0.28, p<0.001), and 24(0.17±0.28,p<0.001) months.

Conclusions:

In the XEN-solo group the proportion of a decrease in BCVA (≥ 2 lines) was 19% after 1 year (11% after 2 years), in the combined group 9% after 1 year (6% after 2 years). A higher risk for a decrease in BCVA was a better baseline visual acuity in XEN-solo-procedures (18% vs. 4%, p=0.037), and the presence of PEX in XEN-solo-procedures (23 vs. 8%, p=0.045).The present study shows good visual acuity results after XEN-GGM, which seem to be better than compared to classic trabeculectomy literature.

Financial Disclosure:

receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented