XEN Gel Stent Versus Nonpenetrating Deep Sclerectomy in Ocular Hypertension and Open Angle Glaucoma Patients

Abstract

Précis: XEN gel stent and nonpenetrating deep sclerectomy, both either alone or in combination with cataract surgery, significantly lowered the intraocular pressure (IOP) and reduced the number of antiglaucoma medications in patients with open angle glaucoma, with no significant differences between them. Purpose: To compare the surgical outcomes of XEN45 implant and nonpenetrating deep sclerectomy (NPDS), either alone or in combination with cataract surgery, in patients with ocular hypertension and open angle glaucoma (OAG). A retrospective and single-center cohort study was conducted on consecutive patients who underwent a XEN45 implant or an NPDS, either alone or in combination with phacoemulsification. The primary endpoint was the mean change in IOP from the 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±5.3 mm Hg and 17.8±6.2 mm Hg to 12.6±2.6 mm Hg and 13.8±2.8 mm Hg at month 12 in the XEN and NPDS groups, respectively; P<0.0001 each. At month 12, 70 (54.7%) eyes were classified as a 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±0.7–0.2±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. Conclusions: 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 ocular hypertension and patients with open angle glaucoma.

Stromal lenticule addition keratoplasty with corneal crosslinking for corneal ectasia secondary to FS-LASIK: a case series

“…Compared with our cases, they may show potential advantages of reducing the risk of lenticule dislocation as it is more firmly implanted [26] . However, as the remaining stromal bed is thin in patients with advanced corneal ectasia, creating a new stromal bed may elicit further risk of disease progression and the implantation process has been reported to cause complications such as perforation and laceration that eventually leads to surgical failure [11,[29][30] . Thus, in our study, we choose to use the existing flap to allocate the lenticule instead of creating a new stromal pocket.…”

HHO optimized support vector machine classifier for traditional Chinese medicine syndrome differentiation of diabetic retinopathy

“…With the development of machine learning technology, there are more and more applications in the field of medical disease diagnosis. For example, Support Vector Machine (SVM) [12] , Gradient Boosting [13] , Adaptive Boosting (AdaBoost) [14] , K-nearest Neighbor (KNN) algorithms [15] , and other machine learning technologies are used to establish corresponding disease diagnosis models. TCM intelligent syndrome differentiation has become a hot spot and has made some achievements [16][17][18] .…”