Posters

Comparison of 1 year outcomes of XEN implantation alone vs combined phacoemulsification-XEN surgery

Poster Details

First Author: N.Moura-Coelho PORTUGAL

Co Author(s):    D. Hipolito Fernandes   S. Crisostomo   A. Basilio   M. Dutra-Medeiros   M. Sa Cardoso   T. Gomes     

Abstract Details

Purpose:

To compare the 1-year efficacy and safety of the XEN45 Gel Stent (Allergan, Irvine, CA) implantation alone versus combined Xen implantation and phacoemulsification (Phaco-Xen) in patients with medically refractory open-angle glaucoma (mrOAG).

Setting:

Department of Ophthalmology, Central Lisbon Hospital Centre, Lisbon (Portugal).

Methods:

Retrospective comparative interventional case series of 19 eyes (18 patients) with mrOAG who underwent XEN surgery (isolated or Phaco-Xen) at our institution, a tertiary center for Ophthalmology in Portugal reporting the initial experience with XEN nationwide. Outcomes measured at 12-month follow-up included intra-ocular pressure (IOP) reduction and reduction rate (IOP-RR), number of IOP-lowering drugs, and complications. Success was defined as IOP-RR ≥ 20% and IOP < 18 mmHg and > 5 mmHg, with (qualified) or without (complete) need for IOP-lowering drugs, without further procedures for glaucoma including needling.

Results:

At 12-month post-XEN implantation, there was significant reduction in median IOP (5,0 mmHg, p-value = 0,050) in the isolated XEN group, but not in the Phaco-Xen group (median IOP reduction 8,0 mmHg, p-value = 0,123). Nevertheless, no statistically significant differences between both patient groups were observed in IOP-RR (p-value = 0,680) drug reduction (p-value = 0,056), number of successful cases (p-value = 0,605), and number of complications (p-value= 0,457).

Conclusions:

In our study, XEN implantation showed good efficacy in medically refractory OAG at 1 year. Combining cataract surgery showed neither added IOP-lowering benefit nor association with inferior success or increased number of complications. Larger, prospective studies are needed to ascertain whether cataract surgery may have an added IOP-lowering benefit in XEN surgery.

Financial Disclosure:

None