Primary Versus Posttrabeculectomy XEN45 Gel Stent Implantation: Comparison of Success Rates and Intraocular Pressure-lowering Potential in Pseudophakic Eyes. Issue 12 (December 2020)

• Record Type: Journal Article
• Authors: Widder, Randolf A.; Lappas, Alexandra; Rennings, Corinna; Hild, Matthias; Dietlein, Thomas S.; Roessler, Gernot F.
• Is Part Of: Journal of glaucoma. Volume 29:Issue 12(2020)
• Publication Date: 2020-12
• Subjects: glaucoma -- glaucoma surgery -- MIGS -- XEN -- trabeculectomy; Glaucoma -- Periodicals; 617.741005
• DOI: 10.1097/IJG.0000000000001649
• Languages: English
• ISSNs: 1057-0829

Abstract

Abstract : Precis: The XEN45 Gel Stent can be implanted after failed trabeculectomy without disadvantages compared with primary implantation. Purpose: We aimed to compare the outcomes of XEN45 Gel Stent implantation in pseudophakic eyes after failed trabeculectomy and in pseudophakic eyes without other previous surgeries. Patients and Methods: In this retrospective study, we included 30 pseudophakic eyes of 30 patients who underwent XEN45 Gel Stent implantation after failed trabeculectomy (trabeculectomy group) and 60 eyes of 60 patients with primary XEN45 Gel Stent implantation (control group). The groups were matched for preoperative intraocular pressure (IOP), preoperative medication score, cup-to-disc ratio, follow-up time, visual acuity, and age at a ratio of 1:2. Eyes with concomitant eye diseases, those who had undergone previous surgery, and those with a follow-up duration <6 months were excluded. We compared the success rates on the basis of different criteria: Criteria A (IOP<21 mm Hg, IOP reduction>20%, no repeat surgery); Criteria B (IOP<18 mm Hg, IOP reduction>20%, no repeat surgery); and Criteria C (IOP⩽15 mm Hg, IOP reduction≥40%, no repeat surgery). Results: After an average follow-up period of 20 months, the mean IOP was reduced from 24.4±5.7 to 14.0±4.1 mm Hg in all the study subjects (90 patients). There were no significant differences between the 2 groups in postoperative IOP, postoperative medication score, revision rate, and repeat surgery rate or success rate. Conclusions: XEN45 Gel Stent implantation is a viable option after failed trabeculectomy. According to our results, it has no disadvantage compared with primary XEN45 Gel Stent implantation.