Clinical Ophthalmology (Apr 2023)

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

  • Marcos-Parra MT,
  • Salinas-López JA,
  • Mateos-Marcos C,
  • Moreno-Castro L,
  • Mendoza-Moreira AL,
  • Pérez-Santonja JJ

Journal volume & issue
Vol. Volume 17
pp. 1223 – 1232

Abstract

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Maria Teresa Marcos-Parra, Javier Alejandro Salinas-López, Carlos Mateos-Marcos, Lucia Moreno-Castro, Angi Lizbeth Mendoza-Moreira, Juan J Pérez-Santonja Ophthalmology Department, Hospital General Universitario de Alicante, Alicante, SpainCorrespondence: Maria Teresa Marcos-Parra, Ophthalmology Department, Hospital General Universitario de Alicante, Pintor Baeza, 11, Alicante, 03010, Spain, Tel +34 965 93 30 00, Email [email protected]: 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). Thirty-six (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.Keywords: open-angle glaucoma, MIGS, XEN45, intraocular pressure, learning-curve

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