Michael Smith1, Roselin Charles2, Ahmed Abdel-Hay3, Brinda Shah4, Daniel Byles2, Lei-Ai Lim3, Jonathan Rossiter3, Chih-Hung Kuo5,6, Peter Chapman4, Shalini Robertson4. 1. West of England Eye Unit, Royal Devon and Exeter Hospital, Exeter, UK. Michael.smith26@nhs.net. 2. West of England Eye Unit, Royal Devon and Exeter Hospital, Exeter, UK. 3. Ophthalmology Department, Musgrove Park Hospital, Taunton, UK. 4. Ophthalmology Department, Yeovil Hospital, Yeovil, UK. 5. Ophthalmology Department, Gold Coast University Hospital, Gold Coast, Australia. 6. Sydney Medical School, Sydney, Australia.
Abstract
OBJECTIVES: To describe the 12-month outcomes of the Xen45 glaucoma stent. METHODS: Non-comparative retrospective study of all cases who underwent Xen glaucoma surgery in April 2017 or earlier and completed 12 months of follow-up. The primary outcome measures were intraocular pressure (IOP) reduction and number of glaucoma medications at 12 months postoperatively. The secondary outcome measures were surgical complications and the success rate of surgery at 1 year. Success rate was defined according to the multiple IOP thresholds of 15 mmHg, 18 mmHg, and 21 mmHg with all requiring a drop of 20% and no additional glaucoma surgery. Revision or needling of the Xen conjunctival bleb was not considered to constitute a surgical failure. RESULTS: Sixty-eight eyes were included in the study. Mean IOP dropped from 22.1 mmHg preoperatively to 14.8 mmHg at 12 months, a 33% drop (p < 0.0001). Mean number of glaucoma medications reduced from 2.9 preoperatively to 1.1 at 12 months (p < 0.0001). In total, 54.4% of cases were back on glaucoma medications by 12 months. Success rate varied from 32.4% when defined as IOP ≤ 15 mmHg and ≥ 6 mmHg and ≥ 20% reduction without medications to 70.6% when defined as IOP ≤ 21 mmHg and ≥ 6 mmHg and ≥ 20% reduction with or without medications. Thirty cases (44.1%) required bleb needling or surgical revision. CONCLUSIONS: The Xen45 is effective at reducing IOP and glaucoma medication use at 12 months postoperatively. Patients considering this procedure should be warned that by 12 months postoperatively there is a significant chance of requiring postoperative bleb intervention and glaucoma drops.
OBJECTIVES: To describe the 12-month outcomes of the Xen45 glaucoma stent. METHODS: Non-comparative retrospective study of all cases who underwent Xen glaucoma surgery in April 2017 or earlier and completed 12 months of follow-up. The primary outcome measures were intraocular pressure (IOP) reduction and number of glaucoma medications at 12 months postoperatively. The secondary outcome measures were surgical complications and the success rate of surgery at 1 year. Success rate was defined according to the multiple IOP thresholds of 15 mmHg, 18 mmHg, and 21 mmHg with all requiring a drop of 20% and no additional glaucoma surgery. Revision or needling of the Xen conjunctival bleb was not considered to constitute a surgical failure. RESULTS: Sixty-eight eyes were included in the study. Mean IOP dropped from 22.1 mmHg preoperatively to 14.8 mmHg at 12 months, a 33% drop (p < 0.0001). Mean number of glaucoma medications reduced from 2.9 preoperatively to 1.1 at 12 months (p < 0.0001). In total, 54.4% of cases were back on glaucoma medications by 12 months. Success rate varied from 32.4% when defined as IOP ≤ 15 mmHg and ≥ 6 mmHg and ≥ 20% reduction without medications to 70.6% when defined as IOP ≤ 21 mmHg and ≥ 6 mmHg and ≥ 20% reduction with or without medications. Thirty cases (44.1%) required bleb needling or surgical revision. CONCLUSIONS: The Xen45 is effective at reducing IOP and glaucoma medication use at 12 months postoperatively. Patients considering this procedure should be warned that by 12 months postoperatively there is a significant chance of requiring postoperative bleb intervention and glaucoma drops.
Authors: Arsham Sheybani; Markus Lenzhofer; Melchior Hohensinn; Herbert Reitsamer; Iqbal Ike K Ahmed Journal: J Cataract Refract Surg Date: 2015-10-23 Impact factor: 3.351
Authors: V T Pérez-Torregrosa; Á Olate-Pérez; M Cerdà-Ibáñez; A Gargallo-Benedicto; V Osorio-Alayo; A Barreiro-Rego; A Duch-Samper Journal: Arch Soc Esp Oftalmol Date: 2016-03-16
Authors: Steven J Gedde; William J Feuer; Wei Shi; Kin Sheng Lim; Keith Barton; Saurabh Goyal; Iqbal I K Ahmed; James Brandt Journal: Ophthalmology Date: 2018-02-21 Impact factor: 12.079
Authors: Huub J Poelman; Jan Pals; Parinaz Rostamzad; Wichor M Bramer; Roger C W Wolfs; Wishal D Ramdas Journal: J Clin Med Date: 2021-03-07 Impact factor: 4.241