Endothelial Cell Density After XEN Implant Surgery: Short-term Data From the Italian XEN Glaucoma Treatment Registry (XEN-GTR). Issue 7 (July 2021)

• Record Type: Journal Article
• Authors: Oddone, Francesco; Roberti, Gloria; Posarelli, Chiara; Agnifili, Luca; Mastropasqua, Leonardo; Carnevale, Carmela; Micelli Ferrari, Tommaso; Pace, Vincenzo; Sacchi, Matteo; Cremonesi, Elena; Uva, Maurizio; Menchini, Martina; Brescia, Lorenza; Figus, Michele
• Is Part Of: Journal of glaucoma. Volume 30:Issue 7(2021)
• Publication Date: 2021-07
• Subjects: glaucoma -- corneal endothelial cells -- corneal endothelial density -- XEN implant -- minimally invasive glaucoma surgery -- Italian XEN Glaucoma Treatment Registry -- XEN-GTR; Glaucoma -- Periodicals; 617.741005
• DOI: 10.1097/IJG.0000000000001840
• Languages: English
• ISSNs: 1057-0829

Abstract

Abstract : Precis: XEN implant was associated with low endothelial cell density (ECD) reduction. In fact, when combined with phacoemulsification, the reduction in ECD was similar to that expected after phacoemulsification alone. Purpose: The purpose of this study was to assess the impact of XEN implant, either alone or in combination with phacoemulsification, on ECD. Methods: Multicenter, prospective, observational study conducted on consecutive open-angle glaucoma patients, who were enrolled in the Italian XEN Glaucoma Treatment Registry and have complete endothelial cell count data at baseline and at 6 months after implantation. The primary endpoint was the mean percentage change in ECD between baseline and month 6. Results: The study included 108 open-angle glaucoma eyes (68 in the XEN-solo and 40 eyes in the XEN+phaco groups) and 60 control eyes (phaco-solo group). As compared with baseline, mean (95% confidence interval, CI) ECD reduction was −5.6% (−7.0% to −4.9%), −11.3% (−13.8% to −10.9%), and −13.0% (14.8% to −11.8%) in the XEN-solo, XEN+phaco, and phaco-solo groups, respectively ( P =0.0004, <0.0001, and <0.0001, respectively). As compared with the XEN-solo group, the ECD reduction was significantly greater in the XEN+phaco group (mean difference=5.7%; 95% CI: 4.1%-7.3%, P <0.0001) and in the phaco-solo group (mean difference=7.4%; 95% CI: 5.7%-9.1%, P <0.0001). ECD reduction was similar in XEN+phaco and phaco-solo groups ( P =0.9). In absolute terms, ECD reduction was significantly greater in the XEN+phaco (mean difference=169±306, P =0.021) and in the phaco-solo (mean difference=192±302, P =0.0022) groups than in the XEN-solo group. Conclusions: The mean ECD reduction 6 months after XEN implantation was low. The ECD reduction in the XEN+phaco group was larger than in the XEN-solo group but was similar to that observed in the phaco-solo group.