Efficacy of the XEN gel stent on intraocular pressure lowering in East Asian eyes.

Abstract

This study aims to evaluate the efficacy and safety of XEN45 gel stent (Allergan plc, Dublin, Ireland) in East Asian patients with glaucoma. A retrospective study of consecutive XEN45 gel stent implantation surgeries with or without concurrent cataract surgery from May 2017 to August 2018 was performed in a single institution. The clinical charts of all cases were reviewed to examine the safety and efficacy of the implant. Primary outcome measures were intraocular pressure (IOP), number of topical glaucoma medications required, additional procedures done and adverse outcomes. All patients included were required to fulfil a minimum of three follow-up visits by post-operative month 1. Sixty-three eyes were included in the study. The median duration of follow-up was 6months [interquartile range (IQR) 2-9]. Median IOP was significantly lowered from 19mmHg (IQR 16-24) pre-operatively to 15mmHg (IQR 11-18) at the end-of-follow-up (p < 0.001). The median number of medications was reduced from 3 (IQR 2-4) at baseline to 0 (IQR 0-2) at the end-of-follow-up (p < 0.001). 66.7% of patients were medication-free by the end of follow-up. Post-operative bleb intervention was required for 61.9% of eyes. Adverse events included post-operative hypotony requiring intervention (4.8%) and post-operative gross hyphaema (9.6%). The XEN45 gel stent when used as a sole procedure or in combination with cataract surgery in East Asian eyes is effective in the treatment of glaucoma. However, a high rate of post-operative bleb intervention appears to be required to support its efficacy.