Long-Term Effectiveness of XEN 45 Gel-Stent in Open-Angle Glaucoma Patients

Abstract

To assess the effectiveness of XEN45, either alone or in combination with phacoemulsification, in open-angle glaucoma (OAG) patients in clinical practice. Methods: Retrospective and single-center study conducted on OAG patients who underwent XEN45 implant, either alone or in combination with cataract surgery. We compared the clinical outcomes of the eyes of thosewho underwent XEN-solo versus those who underwent XEN+Phacoemulsification. The primary endpoint was the mean change in intraocular pressure (IOP) from baseline to the last follow-up visit. Results: A total of 154 eyes, 37 (24.0%) eyes that underwent XEN-solo and 117 (76.0%) eyes that underwent XEN +Phacoemulsification, were included. The mean preoperative IOP was significantly lowered from 19.1±5.0 mmHg to 14.9±3.8 mmHg at month-36, p<0.0001. Preoperative IOP was significantly lowered from 21.2±6.2 mmHg and 18.4±4.3 mmHg to 14.3 ±4.0 mm Hg and 15.2±3.7 mmHg at month-36 in the XEN-solo and XEN+Phacoemulsification groups, p<0.0004 and p=0.0009; with no significant differences between them. In the overall study population, the mean number of antiglaucoma medications was significantly reduced from 2.1±0.8 to 0.2±0.6, p<0.0001. There were no significant differences in the proportion of eyes with a final IOP ≤14 mmHg and ≤16 mmHg between XEN-solo and XEN+Phaco groups (p=0.8406 and 0.04970, respectively). Thirtysix (23.4%) eyes required a needling procedure. Conclusion: XEN implant significantly lowered IOP and reduced the need of ocular hypotensive medication, while maintaining a good safety profile. Beyond week-1, there were no significant differences in IOP lowering between XEN-solo and XEN +Phacoemulsification groups.

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

“…Nevertheless, XEN has been associated with lower conjunctival manipulation and incidence of postoperative complications and adverse effects [ 12 , 48 , 93 , 100 ].…”

Minimally Invasive Glaucoma Surgery

“…118,123 Bleb needling is often required in up to 23% to 36% of cases. 124,125 Less frequently observed complications include corneal edema, subconjunctival hemorrhage, endophthalmitis, and iridodialysis, each occurring in ≤ 1.5% of cases. 118,120,121,123 Overall, within a follow-up period of 1 to 2 years, ~1.5% to 13.8% of patients who received XGS required additional glaucoma surgery to achieve adequate IOP control.…”