Abstract
The purpose of this study is to evaluate the efficacy and complications of the XEN implant as a solo procedure or in association with cataract surgery in patients with open angle glaucoma (OAG). All patients who received a XEN implant between June 2017 and June 2018 were included in the study. The primary and secondary outcomes were: the reduction of the intraocular pressure (IOP) at 6 months postoperatively, the decrease of the glaucoma medications 6 months after surgery, the clinical success rate (eyes (%) achieving ≥20% IOP reduction on the same or fewer medications without secondary surgical intervention), the frequency and type of postoperative interventions as well as the complication rate. We included one hundred and seven eyes from 97 patients with primary OAG (79%), or secondary OAG (21%). Seventy-seven patients (72%) received a standalone XEN implantation and 30 (28%) underwent XEN implantation combined with phacoemusification. The IOP decreased from 20.4 mm Hg ± 6.4 preoperatively to 15.4 mm Hg ± 5.3 six months after the surgery, which represented a reduction of 24.5% (P = 1.4.10−7). It was associated with a lowering of glaucoma medications from 2.8 ± 1.0 preoperatively to 0.6 ± 1.0 six months postoperatively (P = 3.6.10−34). The clinical success rate was 67.2% six months after the surgery. The most frequent complications were: IOP spikes >30 mmHg (16.8%), improper position or angled drain (14.0%) and transient minimal hyphema (<1 week) (11.2%). During the follow-up, the needling was required in 34.6% of cases and a total of 10 eyes (9.4%) required a new glaucoma surgery. To conclude XEN implantation appears to be an effective short- and mid-term surgical technique to control IOP in OAG with a low risk of complication. However postoperative maneuvers were frequently required to maintain efficiency.
Highlights
The purpose of this study is to evaluate the efficacy and complications of the XEN implant as a solo procedure or in association with cataract surgery in patients with open angle glaucoma (OAG)
Nowadays, reducing the intraocular pressure (IOP) is the only effective therapeutic strategy to stop the progression of glaucoma[3,4,5], it includes pressure-lowering eye-drops, laser treatments and surgery
In the case of open angle glaucoma (OAG), the most performed glaucoma surgeries are trabeculectomy and non-penetrating deep sclerectomy (NPDS). These two techniques are based on a derivation of the aqueous humor towards the subconjunctival space by creating a filtration bleb (FB)
Summary
The purpose of this study is to evaluate the efficacy and complications of the XEN implant as a solo procedure or in association with cataract surgery in patients with open angle glaucoma (OAG). In the case of open angle glaucoma (OAG), the most performed glaucoma surgeries are trabeculectomy and non-penetrating deep sclerectomy (NPDS) These two techniques are based on a derivation of the aqueous humor towards the subconjunctival space by creating a filtration bleb (FB). XEN glaucoma stent is a 6 mm long collagen tube with a 45 μm lumen implanted through the anterior chamber into the irido-corneal angle to connect the anterior chamber with the subconjunctival space[11,12,13] This new technique avoids complications related to conjunctival dissection, and aims to reduce operating time. The purpose of this study was to evaluate the efficacy and safety of this new technique within the first 6-month after surgery
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