Effectiveness and Safety of Xen Gel Stent in Glaucoma Surgery: A Systematic Review of the Literature

Traverso, Carlo Enrico; Carassa, Roberto; Fea, Antonio; Figus, Michele; Astarita, Carlo; Piergentili, Benedetta; Vera, Vanessa; Gandolfi, Stefano

doi:10.3390/jcm12165339

Cited by 8 publications

(10 citation statements)

References 126 publications

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“…Presently, there were no available treatments to restore lost vision from glaucoma, emphasizing the importance of early detection and effective intervention ( Jayaram et al, 2023 ). While lowering intraocular pressure had benefited numerous glaucoma patients, its clinical efficacy for an increasing number of individuals remained inadequate ( Jayaram et al, 2023 ; Traverso et al, 2023 ). Thus, understanding the molecular mechanisms driving glaucoma development and devising novel therapies based on these mechanisms were crucial for enhancing clinical outcomes.…”

Section: Discussionmentioning

confidence: 99%

Identification of immune-related biomarkers for glaucoma using gene expression profiling

Wang,

Pu,

Tan

et al. 2024

Front. Genet.

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Introduction: Glaucoma, a principal cause of irreversible vision loss, is characterized by intricate optic neuropathy involving significant immune mechanisms. This study seeks to elucidate the molecular and immune complexities of glaucoma, aiming to improve our understanding of its pathogenesis.Methods: Gene expression profiles from glaucoma patients were analyzed to identify immune-related differentially expressed genes (DEGs). Techniques used were weighted gene co-expression network analysis (WGCNA) for network building, machine learning algorithms for biomarker identification, establishment of subclusters related to immune reactions, and single-sample gene set enrichment analysis (ssGSEA) to explore hub genes’ relationships with immune cell infiltration and immune pathway activation. Validation was performed using an NMDA-induced excitotoxicity model and RT-qPCR for hub gene expression measurement.Results: The study identified 409 DEGs differentiating healthy individuals from glaucoma patients, highlighting the immune response’s significance in disease progression. Immune cell infiltration analysis revealed elevated levels of activated dendritic cells, natural killer cells, monocytes, and immature dendritic cells in glaucoma samples. Three hub genes, CD40LG, TEK, and MDK, were validated as potential diagnostic biomarkers for high-risk glaucoma patients, showing increased expression in the NMDA-induced excitotoxicity model.Discussion: The findings propose the three identified immune-related genes (IRGs) as novel diagnostic markers for glaucoma, offering new insights into the disease's pathogenesis and potential therapeutic targets. The strong correlation between these IRGs and immune responses underscores the intricate role of immunity in glaucoma, suggesting a shift in the approach to its diagnosis and treatment.

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Section: Discussionmentioning

confidence: 99%

Identification of immune-related biomarkers for glaucoma using gene expression profiling

Wang,

Pu,

Tan

et al. 2024

Front. Genet.

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“…Although there were no significant differences between the number of excluded eyes (4 eyes in the not-long-AL eyes and 1 eye in the long-AL eyes) within the follow-up period in the present study, further prospective study with longer follow up period would provide valuable insights into the long-term effectiveness and safety of phaco-LOT. In addition, a comparative study with the group undergoing a different minimally invasive glaucoma surgery would enable a more comprehensive evaluation of treatment effectiveness [ 34 , 35 ]. However, we show that certain factors influence IOP elevation or poorer IOP reduction in long-AL eyes after phaco-LOT, especially in the early postoperative period.…”

Section: Discussionmentioning

confidence: 99%

The effect of axial length on the short-term outcomes of cataract surgery combined with ab interno trabeculotomy

Goto,

Honjo,

Omoto

et al. 2023

Graefes Arch Clin Exp Ophthalmol

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Purpose Minimally invasive glaucoma surgery is safer and effective surgical modality for patients with glaucoma. To compare the effect of axial length (AL) on the surgical outcomes of combined cataract surgery and ab interno trabeculotomy (phaco-LOT), a retrospective, non-randomized comparative study was performed. Methods In total, 458 eyes of 458 open-angle glaucoma patients who underwent phaco-LOT and were followed-up without any intervention for at least 6 months were enrolled. All were divided into a long-AL group (AL ≥ 26.0 mm, 123 eyes) and a not-long-AL group (AL < 26.0 mm, 335 eyes). The principal outcomes were the changes in intraocular pressure (IOP) and medication scores. We also sought a correlation between postoperative IOP spike and hyphema. Results Significant postoperative reductions in IOP and medication scores were apparent in all subjects. The IOP reductions were significant at all timepoints in the not-long-AL group, but not until 1 month postoperatively in the long-AL group, and the IOP change was significantly lower in the long-AL group from postoperative day 1 to 3 months. On subanalysis of subjects by age, the microhook used, the pre-operative IOP, and the medication score, a significantly higher incidence of IOP spike was observed in the long-AL group in weeks 1 and 2 (both p < 0.05), but this did not correlate with hyphema status, implying that a different mechanism was in play. Conclusion Phaco-LOT was effective regardless of AL, but the postoperative IOP decrease was lower and the early postoperative incidence of IOP spike was higher in long-AL eyes.

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“…The Xen implant stent is a hydrophilic tube that is 6 mm long with a lumen of 45 μm, and it is composed of porcine gelatine crosslinked with glutaraldehyde to prevent degradation when implanted [ 86 ]. In 2018, Sng et al published the first results with Xen-45 in UG.…”

Section: Minimally Invasive Glaucoma Surgical (Migs) Devices In Uveit...mentioning

confidence: 99%

Update on Diagnosis and Treatment of Uveitic Glaucoma

Halkiadakis,

Konstantopoulou,

Tzimis

et al. 2024

JCM

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Glaucoma is a common and potentially blinding complication of uveitis. Many mechanisms are involved alone or in combination in the pathogenesis of uveitic glaucoma (UG). In terms of diagnostic evaluation, the effects of inflammatory activity in the retinal nerve fiber layer may be a source of bias in the interpretation of optical coherence tomography measurements. For the successful treatment of UG, the control of intraocular inflammation specific to the cause or anti-inflammatory treatment, combined with IOP management, is mandatory. The early institution of specific treatment improves the prognosis of UG associated with CMV. The young age of UG patients along with increased failure rates of glaucoma surgery in this group of patients warrants a stepwise approach. Conservative and conjunctival sparing surgical approaches should be adopted. Minimally invasive surgical approaches were proved to be effective and are increasingly being used in the management of UG along with the traditionally used techniques of trabeculectomy or tubes. This review aims to summarize the progress that recently occurred in the diagnosis and treatment of UG.

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Effectiveness and Safety of Xen Gel Stent in Glaucoma Surgery: A Systematic Review of the Literature

Cited by 8 publications

References 126 publications

Identification of immune-related biomarkers for glaucoma using gene expression profiling

Identification of immune-related biomarkers for glaucoma using gene expression profiling

The effect of axial length on the short-term outcomes of cataract surgery combined with ab interno trabeculotomy

Update on Diagnosis and Treatment of Uveitic Glaucoma

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