Ophthalmology and Therapy (Jun 2019)

Comparison of Minimally Invasive XEN45 Gel Stent Implantation in Glaucoma Patients Without and With Prior Interventional Therapies

  • Fritz H. Hengerer,
  • Gerd Auffarth,
  • Ina Conrad-Hengerer

DOI
https://doi.org/10.1007/s40123-019-0193-7
Journal volume & issue
Vol. 8, no. 3
pp. 447 – 459

Abstract

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Abstract Introduction The aim of our analysis was to compare the effectiveness of the XEN45 gel stent implantation in patients without and with prior glaucoma intervention. Methods Retrospective analysis including 148 medical records of consecutive glaucoma eyes without prior glaucoma intervention (group A, n = 45) or with prior glaucoma intervention (group B, n = 103). Follow-up data up to 12 months after XEN45 gel implantation were available for all eyes. Results At 12 months, qualified success (IOP reduction of ≥ 20% and IOP < 18 mmHg without and with medication) was achieved in 76% of eyes in group A and in 72% of eyes in group B; corresponding values for complete success (IOP reduction of ≥ 20% and IOP < 18 mmHg without medication) were 56% and 55%. Mean IOP was significantly reduced by 58% from 36.0 ± 10.7 mmHg preoperatively to 14.2 ± 3.4 mmHg at 12 months in group A (p = 0.000) and by 53% from 31.6 ± 8.9 mmHg to 14.3 ± 4.2 mmHg and in group B (p = 0.000). The mean number of hypotensive medications had significantly decreased from 3.6 ± 0.8 at baseline to 0.3 ± 0.7 medications in group A (p = 0.000) and from 3.0 ± 1.0 to 0.3 ± 0.7 medications in group B (p = 0.000). Needling was required in 29% of eyes in group A and in 35% of group B within 12 months. No statistically significant differences were observed between eyes without and with prior glaucoma intervention. Conclusion The 1-year results of our retrospective analysis indicate that patients without and with previous glaucoma intervention can benefit from XEN45 gel stent implantation. Both groups achieved significant and similar reductions in IOP and hypotensive medication, with a slight trend towards greater reductions in eyes without prior glaucoma intervention. Further controlled prospective studies with longer follow-ups are required. Funding Editorial support and article processing charges were funded by Allergan.

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