XEN® implant and trabeculectomy medium-term quality of life assessment and comparison of results

Basílio, A.L.; Moura-Coelho, Nuno; Passos, Inês; Cardoso, Mariana; Domingues, I.; Reina, Maria; Flores, Rita; Gomes, Tamara Maria

doi:10.18240/ijo.2018.12.11

Cited by 9 publications

(7 citation statements)

References 22 publications

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“…Until today, few studies exist comparing the surgical outcome of trabeculectomy combined with MMC and the implantation of a XEN gelstent [8,9,16,17]. Schlenker et al compared the rate of surgical failure after trabeculectomy and XEN gelstent implantation, which directly corresponds to surgical success.…”

Section: Discussionmentioning

confidence: 99%

“…Few studies have yet compared both filtering surgeries, XEN gelstent implantation and trabeculectomy. To this date, no prospective randomized clinical trial exists that compares the two procedures [8,9]. Most recently, Schlenker et al found that there were no detectable evidence of differences in the risk of failure or safety profiles between the two surgical procedures [9].…”

Section: Introductionmentioning

confidence: 99%

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Efficacy and safety of XEN®—Implantation vs. trabeculectomy: Data of a “real-world” setting

et al. 2020

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ObjectiveTo compare surgical success, postoperative intraocular pressure and complication rates between trabeculectomy and XEN gelstent surgery in a cohort of glaucoma patients in a typical clinical setting. MethodsA retrospective cohort study of consecutive patients with refractory open-angle glaucoma including patients who underwent either stand-alone XEN gelstent insertion with Mitomycin C or trabeculectomy with Mitomycin C between 2016 and 2018 at the University Eye Hospital Mainz, Germany. Primary outcome measure was the proportion of surgical success 1 year after surgery. Patients with an IOP �18mmHg, an intraocular pressure reduction of >20% and in no need of revision surgery or topical medication were considered a complete surgical success. If topical therapy was necessary, they were considered a qualified success. Multivariable logistic regression analysis was carried out for the primary outcome including gender, age, preoperative intraocular pressure and number of medication classes used preoperatively as adjustment variables. Results171 eyes of 144 patients were included, including 82 eyes of 58 patients in the XEN group and 89 eyes of 86 patients in the trabeculectomy group. The primary outcome defined as the proportion of surgical success after 1 year (mean 11.1 months ± 2.2) was similar for both groups. The complete success proportion was 65.5% (95%-CI: 55.6-75.9%) in the trabeculectomy group, and 58.5% (95%-CI: 47.6-69.4%) in the XEN group and not statistically different in our analysis model (crude OR = 0.61; 95%-CI: 0.31-1.22; adjusted OR = 0.66; 95%-CI: 0.32-1.37). The intraocular pressure reduction, as secondary outcome measure, was higher in the trabeculectomy group (10.5 mmHg) compared to the XEN group (7.2 mmHg; p = 0.003) at the 12-month follow-up.Citation: Wagner FM, Schuster AK-G, Emmerich J, Chronopoulos P, Hoffmann EM (2020) Efficacy and safety of XEN®-Implantation vs. trabeculectomy: Data of a "real-world" setting. PLoS ONE 15(4): e0231614. https://doi.org/10.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of XEN®—Implantation vs. trabeculectomy: Data of a “real-world” setting

et al. 2020

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“…In line with our findings, a previous study reported that GSS scores were significantly lower in patients requiring two or more eye drops per day [ 27 ]. In a study by Basilio et al [ 28 ], GSS scores were compared between patients who underwent minimal invasive glaucoma surgery with Xen ® and trabeculectomy. They did not find a difference between the two groups, but they found a strong negative correlation between the administration of topical anti-hypertensive drugs and GSS scores.…”

Section: Discussionmentioning

confidence: 99%

Glaucoma Medication and Quality of Life after Phacoemulsification Combined with a Xen Gel Stent

Pahljina

Sarny

Hoeflechner

et al. 2022

JCM

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Glaucoma has a significant impact on quality of life. Here, we aimed to evaluate the influence of a reduction in glaucoma medications on quality of life and patient satisfaction after phacoemulsification combined with the Xen gel stent. We carried out a cross-sectional survey of patients who underwent phacoemulsification with the Xen gel stent at the Medical University of Graz, Austria. Quality of life was assessed using the German version of the Glaucoma Symptoms Scale (GSS)—questionnaire. Patients were also asked whether the operation reduced glaucoma medications and to indicate their overall satisfaction from 1 (totally discontented) up to 10 (totally contented). Questionnaires of 80 patients were evaluated. A total of 36 patients (45.0%) reported a reduction in glaucoma medications. Three items of the GSS were significantly better in patients who needed fewer glaucoma medications after the operation (“hard to see in daylight”, 75.0 ± 31.1 vs. 57.7 ± 39.1, p = 0.035; “hard to see in dark places”, 81.1 ± 28.7 vs. 54.9 ± 41.2, p = 0.002; and “halos around lights”, 88.3 ± 25.9 vs. 68.8 ± 38.6, p = 0.002). Patient satisfaction was significantly higher when the procedure led to a reduction in glaucoma medication (8.3 ± 2.0 vs. 6.8 ± 3.1; p = 0.034). The reported quality of life and patient satisfaction were significantly better when phacoemulsification with the Xen gel stent reduced the number of glaucoma medications needed.

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Section: Discussionmentioning

confidence: 99%

“…It has been shown that XEN implantation goes along with a higher rate of bleb needling or revision surgery and this increase is probably explained by increased usage of these implants. 30,31 Another potential factor that might affect the numbers and rates of procedures performed is the role that advertising has for newer procedures compared to older ones. Latest procedures are well advertised and recommended within the group of ophthalmologists and ophthalmic surgeons but might lose their place in the spotlight to newer procedures after a while and therefore be performed less often.…”

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confidence: 99%

Trends in Surgical Glaucoma Treatment in Germany Between 2006 and 2018

Lübke

Boehringer

Anton

et al. 2021

CLEP

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Background/Aims: Surgical procedures in ophthalmology underlie variations over different time periods and are strongly dependent on the technical process and the invention of innovative surgical techniques. Especially, in glaucoma surgery a lot of surgical devices and techniques have been introduced during the last years. Until now, the use of these newer techniques has not been shown on a robust data basis. We herein present the numbers of different types of glaucoma surgeries performed at German hospitals between 2006 and 2018. Methods and Design: The quality reports of hospitals in Germany from 2006 to 2018 were analyzed concerning all procedural codes for glaucoma surgery and intervention. Especially, the change in usage of "classical" and "modern" surgical techniques (MIGS: "minimally invasive glaucoma surgery") or devices was compared. Results: The number of glaucoma procedures performed increased by 75% from 27,811 in 2006 to 48,794 in 2018. Absolute numbers of trabeculectomies, goniotomies, ab externo trabeculotomies and to a certain level cyclodestructive procedures decreased during the examined years while use of MIGS has increased in absolute and relative numbers since 2012. From 2015 a strong increase in the usage of XEN implants could be seen. Drainage implants (such as Baerveldt/Ahmed) showed stable absolute numbers over the time period covered. Absolute numbers of laser trabeculoplasty peaked in 2014 and decreased afterwards. Iridotomies and iridectomies increased by 120%/248% over the whole period. Conclusion:Our data show a trend towards the modern surgical options and especially MIGS during the recent years. Classical procedures showed a decrease in total numbers emphasized from 2013. These numbers confirm the assumption that modern glaucoma surgery is becoming more and more popular and established in German hospitals.

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XEN® implant and trabeculectomy medium-term quality of life assessment and comparison of results

Cited by 9 publications

References 22 publications

Efficacy and safety of XEN®—Implantation vs. trabeculectomy: Data of a “real-world” setting

Efficacy and safety of XEN®—Implantation vs. trabeculectomy: Data of a “real-world” setting

Glaucoma Medication and Quality of Life after Phacoemulsification Combined with a Xen Gel Stent

Trends in Surgical Glaucoma Treatment in Germany Between 2006 and 2018

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