Korean J Ophthalmol.
2023 Oct;37(5):353-364. 10.3341/kjo.2023.0044.
One-Year Outcomes of Ab Externo XEN45 Gel Stent Implantation with an Open Conjunctiva Approach in Patients with Open-Angle Glaucoma
- Affiliations
-
- 1Department of Ophthalmology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea
- 2Department of Ophthalmology, Pusan National University School of Medicine, Busan, Korea
- 3Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
- 4Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
- KMID: 2546486
- DOI: http://doi.org/10.3341/kjo.2023.0044
Abstract
- Purpose
This study aimed to evaluate the 1-year surgical outcomes of XEN45 gel stent implantation with an open conjunctiva approach in patients with open-angle glaucoma (OAG).
Methods
This retrospective cohort study included 19 eyes of 19 patients who underwent XEN45 gel stent implantation with an open conjunctival approach. Surgical success was defined by intraocular pressure (IOP) ≤18 mmHg and one of the following: IOP reduction ≥30% or reduction of two glaucoma medications with final IOP if baseline IOP ≤18 mmHg. The cumulative probability of success rate was analyzed using Kaplan-Meier survival analysis. Cox proportional hazard regression analysis was used to assess prognostic factors for surgical failure.
Results
IOP reduced from 32.37 ± 12.08 mmHg preoperatively to 15.14 ± 2.25 mmHg at 1 year (p = 0.001). The number of glaucoma medication reduced from 3.89 ± 0.32 preoperatively to 0.86 ± 1.35 at 1 year (p = 0.001). The success rates were 78.9% at 6 months and 73.7% at 1 year. Eyes with bleb horizontal extent ≥2 clock hours at 1 month postoperatively had a significantly higher success rate (log-rank test, p < 0.001). Greater bleb horizontal extent at 2 weeks and 1 month postoperatively was associated with a lower surgical failure rate (2 weeks: hazard ratio, 0.119; p = 0.024; 1 month: hazard ratio, 0.046; p = 0.007). Bleb needling and additional glaucoma surgeries were necessary in 10 (52.6%) and five eyes (26.3%), respectively.
Conclusions
XEN45 gel stent implantation with the open conjunctiva approach is effective in reducing IOP and glaucoma medication for over 1 year in patients with OAG.
