XEN Gel Stent Versus Non-penetrating Deep Sclerectomy in Ocular-hypertension and Open-angle Glaucoma Patients.

Abstract

XEN gel-stent and non-penetrating deep sclerectomy, either alone or in combination with cataract surgery, significantly lowered the intraocular pressure and reduced the number of antiglaucoma medications in open-angle-glaucoma patients; with no significant differences between them. To compare the surgical outcomes of XEN45-implant and non-penetrating deep sclerectomy (NPDS), either alone or in combination with cataract surgery, in patients with ocular-hypertension (OHT) and open-angle glaucoma (OAG). Retrospective and single center cohort study conducted on consecutive patients who underwent a XEN45 implant or a NPDS, either alone or in combination with phacoemulsification. The primary endpoint was the mean change in intraocular pressure (IOP) from baseline to the last follow-up visit. One hundred twenty-eight eyes, 65 (50.8%) eyes in the NPDS-group and 63 (49.2%) eyes in the XEN-group, were included in the study. The mean preoperative IOP was significantly lowered from 17.6±5.3mmHg and 17.8±6.2mmHg to 12.6±2.6mmHg and 13.8±2.8mmHg at month-12, in the XEN and NPDS groups, respectively; P<0.0001 each. At month-12, 70(54.7%) eyes were classified as success, with no significant differences between XEN (57.1%; 36/63 eyes) and NPDS (52.3%; 34/65 eyes) (mean difference: 4.8%; 95% CI: -30.5% to 20.8%; P=0.7115). The number of ocular hypotensive medications was significantly reduced in the XEN (from 2.1±0.7 to 0.2±0.5, P<0.0001) and in the NPDS (from 2.0±0.8 to 0.3±0.6, P<0.0001) groups, with no significant differences between them (P=0.2629). The incidence of postoperative adverse events in the overall study population was 12.5%, with no significant differences between groups (P=0.1275). Seven (11.1%) eyes underwent needling (XEN-group) and 10 (15.4%) goniopuncture (NPDS-group); P=0.4753. XEN45-implant and the NPDS, either alone or in combination with cataract surgery, significantly lowered IOP and reduced the number of ocular hypotensive medications in OHT and OAG patients.