Choroidal Detachment after XEN Gel Stent Implantation

Abstract

Background. The purpose of this study is to estimate the incidence of choroidal detachment (CD) after XEN gel stent implant surgery and to evaluate the associated factors. Methods. We reviewed the clinical charts of 126 patients who underwent XEN implantation between March 1, 2016, and December 31, 2018 at the University Eye Clinic of Genoa. Ocular, demographics, and perioperative factor were registered and analysed. Univariate and multivariate logistic analysis were performed to investigate factors associated with CD occurrence. Results. Of the 126 patients, 25 (19.8%) developed a choroidal detachment after XEN gel stent implant surgery. The mean period between surgery and CD detection was 5.84 ± 1.77 days. The mean intraocular pressure (IOP) at the time of CD diagnosis was 6.4 ± 3.1 mmHg. Age (OR = 1.10, p < 0.019 ), early postoperative IOP (OR = 0.70, p < 0.001 ), and number of preoperative IOP-lowering drugs (OR = 5.70, p < 0.001 ) were significantly associated with CD presence. Complete resolution was observed in all the cases. Wide-field imaging and ultrasonography were useful tools to diagnose and follow up CD until resolution. Conclusions. When carefully investigated, CD is a relatively common complication after XEN gel stent implant procedure. Older age, lower postoperative IOP, and higher number of preoperative IOP-lowering drugs were significantly associated with the development of CD.

Appositional Choroidal Detachment Following XEN45 Gel Stent Requiring Surgical Drainage

“…One study focusing on Xen45 Implants in particular found that significant risk factors predisposing for choroidal detachment include increased age, a higher number of preoperative IOP-lowering drugs, and lower IOP within 1 week postoperatively. 15 These major risk factors were seen in our case as well.…”

Trabeculectomy versus Xen gel implant for the treatment of open-angle glaucoma: a 3-year retrospective analysis

“…The assessment of factors associated with the occurrence of this complication was reported in a previous study. 17 In the postoperative management analysis (table 4), the number of postoperative visits showed a marginally significant difference between the two groups. The trabeculectomy group showed fewer postoperative visits over 24 months period, while the difference between the two groups lost significance at 12 months.…”

“…The assessment of factors associated with the occurrence of this complication was reported in a previous study. 17 …”

A Case of Bilateral Choroidal Effusion after XEN Gel Stent Implantation

“…According to recent studies, three main risk factors predispose patients to CD after XEN45 implantation: (i) older age, (ii) excess preoperative medications to lower IOP, and (iii) low IOP within one week after surgery [ 14 ]. Importantly, these risk factors were present in the clinical case reported here, in which persistent serous CD with visual loss occurred in both eyes after XEN45 implantation.…”