Minimally invasive combined glaucoma and cataract surgery: clinical results of the smallest ab interno gel stent

Gregorio, Alessandra De; Pedrotti, Emilio; Russo, Luisa; Morselli, Simonetta

doi:10.1007/s10792-017-0571-x

Cited by 119 publications

(128 citation statements)

References 14 publications

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“…In recent years, the XEN Gel Stent® and other MIGS devices have appeared as alternatives to clinically lower IOP in a safer way than TB when treating glaucoma. One advantage of the XEN Gel Stent® is that it is used Bab interno,^which implies less surgical trauma and fewer time-consuming procedures, such that it has lower rates of intra-and postoperative complications [3,4]. Thus, the use of this device is associated with a less aggressive manipulation of the conjunctiva, which may be relevant in terms of avoiding subconjunctival bleeding and conjunctival perforation [4].…”

Section: Discussionmentioning

confidence: 99%

“…One advantage of the XEN Gel Stent® is that it is used Bab interno,^which implies less surgical trauma and fewer time-consuming procedures, such that it has lower rates of intra-and postoperative complications [3,4]. Thus, the use of this device is associated with a less aggressive manipulation of the conjunctiva, which may be relevant in terms of avoiding subconjunctival bleeding and conjunctival perforation [4]. In addition, the preservation of the conjunctival lymphatic vessels may facilitate more physiological absorption of the aqueous humor [16].…”

Section: Discussionmentioning

confidence: 99%

“…However, TB requires a close post-operative follow-up due to possible complications like overfiltration and hypotony. More recently, minimally invasive glaucoma surgery (MIGS) procedures have been developed that represent safer and less aggressive alternatives to TB [3,4], such as that involving the implantation of a XEN Gel Stent®.…”

Section: Introductionmentioning

confidence: 99%

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Optical coherence tomography analysis of filtering blebs after long-term, functioning trabeculectomy and XEN® stent implant

Teus

Moreno-Arrones

Castaño

et al. 2019

Graefes Arch Clin Exp Ophthalmol

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Purpose The purpose of this study was to use Triton® SweptSource OCT to evaluate the morphology of blebs formed when eyes are treated with XEN® implants and to compare these with the blebs in successfully functioning eyes after trabeculectomy (TB) and with eyes of healthy controls. Methods A cross-sectional, observational study. We analyzed 25 eyes, 15 after TB and 10 with XEN® implants, comparing them with 23 healthy eyes (controls). We evaluated the conjunctival morphology of the eyes using AS-OCT.The main parameters evaluated were bleb height, sub-epithelial fibrosis, epithelial thickness, and changes in intraocular pressure (IOP). Results We found that the filtering blebs formed in eyes in which a XEN® stent was implanted were significantly flatter (bleb height 417 ± 183 μm) than the blebs formed in TB eyes (bleb height 618 ± 256 μm, p < 0.05). Moreover, sub-epithelial fibrosis did not develop in any of the blebs produced by the XEN stent, whereas some fibrosis was evident in 40% of the blebs that formed after TB (p < 0.05). The epithelium was thicker when the XEN implant was used (65 ± 18.5 μm) than when eyes underwent TB (60 ± 17.7 μm), and it was thicker than in control eyes (51 ± 9.7 μm, p < 0.05). Moreover, the decrease in the IOP induced by the XEN® stent (− 8.5 ± 5.3 mmHg) was similar to that produced by TB (− 8.8 ± 5.2 mmHg, p > 0.05). Conclusions Filtering blebs obtained after the introduction of a XEN® stent were morphologically distinct to those produced by TB, and they are more similar to the healthy conjunctiva.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Optical coherence tomography analysis of filtering blebs after long-term, functioning trabeculectomy and XEN® stent implant

Teus

Moreno-Arrones

Castaño

et al. 2019

Graefes Arch Clin Exp Ophthalmol

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“…Non-penetrating glaucoma surgeries have a lower incidence due to a lower risk of post-operative hypotony. Newer MIGS procedures like sub-conjuntival Xen Gel Stent (Allergan Plc, Dublin, Ireland) have also been reported with CD [15–17]. …”

Section: Retinal Complications Following Glaucoma Surgerymentioning

confidence: 99%

Retina and glaucoma: surgical complications

et al. 2018

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BackgroundThe close structural and microcirculatory co-relation between anterior and posterior segments of eye make them very vulnerable to complications when one of them is affected surgically. With the advent of anti-fibrotic agents in the management of glaucoma, the rates of vitreoretinal complications have become more frequent. Main bodyCommon retinal complications after glaucoma surgeries include choroidal detachment; ocular decompression retinopathy; haemorrhagic choroidal detachment; hypotony maculopathy; malignant glaucoma; vitreous haemorrhage; bleb endophthalmitis; retinal detachment. Similarly, intraocular pressure rise is often noted after scleral buckle; pars plana vitrectomy; intravitreal gas injection; silicone oil injection; intravitreal steroid injection.ConclusionThe article provides some insight into some of the complications after glaucoma and retina surgeries, including the pathogenetic mechanisms behind each complication and available management options.

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“…Complete success was achieved in 80.4% and qualified success in 97.5%. There were no major or long-term intra-and postoperative complications during the first year of follow-up [41].…”

Section: Innfocus Is Currently An Investigational Device In the Unitedmentioning

confidence: 82%

Minimally Invasive Modalities for Treatment of Glaucoma: An Update

Lee¹,

Amoozgar²,

Han³

2017

J Clin Exp Ophthalmol

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Purpose of Review: In recent years, Minimally Invasive Glaucoma Surgery (MIGS) and laser-based procedures have been gaining popularity as glaucoma treatment options. As such, they represent active areas of research. This article reviews some of the notable recent and forthcoming developments in this field. Recent Findings:The MIGS devices and cyclophotocoagulation have been focused on achieving satisfactory success rate as either combined with phacoemulsification or standalone procedure. They also have superior safety profile when compared to traditional incisional glaucoma surgeries. In addition to the promising data available thus far, more comprehensive investigations on the long-term efficacy and safety of these interventions are currently underway.Summary: New minimally invasive surgical modalities have shown considerable potential in intraocular pressure (IOP) and the number of post-surgical medications with rare complications. The rising popularity of these devices and procedures may represent a shift in treatment paradigm from medical therapy towards earlier surgical intervention, especially in the treatment of mild-to-moderate glaucoma.

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Minimally invasive combined glaucoma and cataract surgery: clinical results of the smallest ab interno gel stent

Abstract: This study demonstrated that the smaller diameter XEN 45 gel implant is statistically effective in reducing IOP and medications in glaucoma patients with a low rate of complications.

Cited by 119 publications

References 14 publications

Optical coherence tomography analysis of filtering blebs after long-term, functioning trabeculectomy and XEN® stent implant

Optical coherence tomography analysis of filtering blebs after long-term, functioning trabeculectomy and XEN® stent implant

Retina and glaucoma: surgical complications

Minimally Invasive Modalities for Treatment of Glaucoma: An Update

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