A
bstract
Aim
To compare outcomes of
ab interno
XEN gelatin stent (Allergan, Dublin, Ireland) implantation vs trabeculectomy with mitomycin C (MMC).
Materials and methods
A retrospective review was conducted of eyes that underwent standalone XEN implantation or trabeculectomy with MMC at a single institution from 2014 to 2019. Intraocular pressure (IOP), visual acuity, glaucoma medications, complications, and postoperative interventions were evaluated. The primary endpoint was the reduction in IOP at 6 months postoperatively. Secondary endpoints included the incidence of postoperative intervention and complications.
Results
One hundred and seventy-nine eyes were included who underwent XEN (
n
= 90) or trabeculectomy (
n
= 89). The mean age was 74.5 ± 7.6 and 68.1 ± 8.2 years old for the XEN and trab groups, respectively (
p
< 0.001). Baseline IOP for XEN was 17.8 ± 6.0 vs 20.4 ± 9.0 mm Hg for the trab group (
p
= 0.03). At 6 months, mean IOP for XEN group was 13.5 ± 5.9 mm Hg, representing a 24.1% IOP reduction from baseline (
p
< 0.001) while mean for trab group was 10.8 ± 4.8 representing a 47% IOP reduction from baseline (
p
< 0.001). The mean IOP was 2.7 mm Hg lower in trab compared to the XEN group at 6 months (
p
< 0.003). The number of medications was reduced in both groups from 2.9 ± 1.1 and 3.1 ± 0.9 to 1.1 ± 2.3 and 0.8 ± 1.4 by 6 months postoperatively for XEN and trab groups, respectively (
p
< 0.001). Complication rates were low for both groups. The needling rate was 30% in XEN vs 7.9% in the trab group (
p
< 0.001), and 46.1% of eyes in the trab group underwent laser suture lysis. Additionally, IOP reduction and complication rates were similar following XEN in eyes receiving <40 or ≥40 μg of MMC.
Conclusion
XEN implantation produces a substantial reduction in IOP with a favorable safety profile comparable to trabeculectomy. Careful postoperative bleb management is critical to obtain optimum outcomes, and higher MMC doses appear safe and may reduce needling rates.
Clinical significance
This study confirms the safety and efficacy of XEN gelatin stent implantation in comparison to trabeculectomy with MMC.
How to cite this article
Sharpe R, Pham G, Chang P. Comparison of
A
b I
nterno
XEN Gelatin Stent vs Trabeculectomy with Mitomycin C: A Retrospective Study. J Curr Glaucoma Pract 2020;14(3):87–92.
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