Comparison of Clinical Outcomes with Open Versus Closed Conjunctiva Implantation of the XEN45 Gel Stent
| Autor: | Joseph F. Panarelli, Michael V. Boland, Elyse J. McGlumphy, E. Randy Craven, Joel S. Schuman, Anna Do, Jithin Yohannan, Sonal Dangda, Aakriti Shukla |
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| Rok vydání: | 2021 |
| Předmět: |
Intraocular pressure
medicine.medical_specialty Visual acuity genetic structures Minimally invasive glaucoma surgery Gel stent medicine.medical_treatment Glaucoma Cataract Extraction 01 natural sciences Article 03 medical and health sciences 0302 clinical medicine Glaucoma surgery medicine Humans 0101 mathematics Glaucoma Drainage Implants Retrospective Studies Dry needling business.industry 010102 general mathematics MIGS Stent General Medicine Cataract surgery medicine.disease eye diseases Surgery Treatment Outcome 030221 ophthalmology & optometry Stents sense organs medicine.symptom business XEN Conjunctiva Glaucoma Open-Angle |
| Zdroj: | Ophthalmology. Glaucoma |
| ISSN: | 2589-4196 |
| DOI: | 10.1016/j.ogla.2020.12.003 |
| Popis: | Purpose: To describe the efficacy and safety of open versus closed conjunctival implantation of the XEN45 Gel Stent (Allergan Inc). Design: Retrospective, multicenter study. Participants: A total of 137 patients with glaucoma who underwent XEN45 implantation via open or closed conjunctival methods. The XEN45 was implanted as a stand-alone procedure or at the time of cataract surgery by 5 surgeons. Methods: Patient demographics, diagnoses, preoperative and postoperative clinical data, outcome measures including intraocular pressure (IOP), use of glaucoma medications, visual acuity, and complications were collected. Statistical analyses were performed with P < 0.05 as significant. Main Outcome Measures: Failure was defined as less than 20% reduction of IOP from medicated baseline or IOP >21 mmHg at 2 consecutive visits at postoperative month 1 and beyond, the need for subsequent operative intervention or additional glaucoma surgery, or a catastrophic event such as loss of light perception. Eyes that had not failed by these criteria and were not on glaucoma medications were considered complete successes. Eyes that had not failed but required glaucoma medications were defined as qualified successes. Results: Complete success was achieved in 31% and 56% of the closed and open groups, respectively (P = 0.01). Qualified success was achieved in 53% and 71% of the closed and open groups, respectively (P = 0.06). At postoperative month 12, the open conjunctiva group was using fewer glaucoma medications than the closed group (0.9 vs. 1.8, respectively; P = 0.02). At postoperative month 12, the open group had a significantly greater percentage of IOP reduction compared with the closed group (43.1% vs. 24.8%, respectively; P = 0.02). Postoperative needling rates were higher in the closed group compared with the open group (36.1% vs. 11.8%, P = 0.001). Conclusions: Implantation of the XEN45 with opening of the conjunctiva is a safe and efficacious procedure to lower IOP with comparable success rate and lower needling rate compared with the closed conjunctiva technique. Prospective evaluation of the various methods for XEN45 implantation will allow for further comparison. |
| Databáze: | OpenAIRE |
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