Outcomes of 45 μm gelatin stent surgery over 24‐month follow‐up

Abstract

Background:The main objectives of this study were to determine whether known risk factors for trabeculectomy failure similarly influence gelatin stent outcomes and to identify surgical factors which may optimise success.Methods: A retrospective, observational study was conducted at a single centre in Perth, Western Australia over 24 months. Two-hundred and sixty-two eyes of 207 patients underwent XEN-45 stent surgery with various forms of glaucoma.Surgical and postoperative data on subjects undergoing XEN-45 stent surgery was collated. Intraocular pressure (IOP) reduction success was determined using three criteria: 1; IOP <18 mm Hg, 2: IOP <15 mm Hg and 3: >25% IOP reduction from baseline. Kaplan-Meier, mixed effects Cox Proportional hazard model and Chi-Square test were used to measure survival of functioning stents. Results:The success rates at a maximum of 2 years after surgery by criteria 1, 2 and 3 were 61.3%, 26.2% and 28.9% in primary open angle glaucoma (n = 243), 18.8%, 16.9%, 21.4% in angle closure glaucoma (n = 11), 0%, 0%, 66.7% in congenital glaucoma (n = 5) and 0% in uveitic glaucoma (n = 3). No significant reduction in success was found in those eyes that had prior ocular surgery (all p > 0.07).

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

“…Thirty-four studies have evaluated the IOP lowering effect of the XEN device over 12 months of follow-up (see Table 2 ). On average, the results of the different studies pointed in the same general direction, mostly indicating that XEN45 provided IOPs below 15 mmHg after one year of follow-up ( Table 2 ), which is consistent with the most recent meta-analysis published [ 12 , 101 , 102 ].…”

“…Six papers have evaluated the longer-term efficacy of XEN45 in terms of IOP lowering and reducing the number of ocular hypotensive medications, (See Table 4 ). With the exception of one paper (n = 23 eyes), which reported an IOP of 19.6 ± 2.1 mmHg at 36 months [ 78 ], currently available evidence shows good hypotensive effects for XEN45, with IOPs at 36–48 months in the range of 13–14 mmHg, as well as a significant reduction in the number of ocular hypotensive medications [ 45 , 61 , 81 , 87 , 88 , 94 , 101 ]. In addition, compared to preoperative values, the reduction in IOP was greater than 30% ( Table 4 ).…”