Ibáñez-Muñoz Ana, Soto-Biforcos Víctor Santiago, Chacón-González María, Rúa-Galisteo Oscar, Arrieta-Los Santos Alexandra, Lizuain-Abadía María Ester, Del Río Mayor José Luis
Department of Ophthalmology, San Pedro Hospital, Logroño, Spain.
Eur J Ophthalmol. 2019 May;29(3):309-314. doi: 10.1177/1120672118795063. Epub 2018 Aug 27.
To evaluate the intraocular pressure-lowering effect, the safety profile, and the success rate of the XEN45 Gel Stent (Allergan, Dublin, Ireland) in patients with pseudoexfoliative glaucoma.
Retrospective study conducted on patients with pseudoexfoliative glaucoma, with or without cataract, who underwent XEN45 implantation surgery with subconjunctival mitomycin-C and had a minimum postoperative follow-up period of 12 months. The primary outcome measure was intraocular pressure reduction at 1 year as compared to baseline. Complete success was defined as a postoperative intraocular pressure reduction of ⩾20% from preoperative baseline at 12 months without any glaucoma medications. Qualified success was defined as a postoperative intraocular pressure reduction of ⩾20% at 12 months with medications.
Of the 24 screened patients, 21 eyes of 20 patients met the inclusion/exclusion criteria and were included in the study. A total of 13 (62%) eyes underwent XEN alone surgery and 8 (38%) eyes had combined XEN + cataract surgery. Mean intraocular pressure was significantly reduced from 21.1 (3.8) mmHg at baseline to 15.2 (3.9) mmHg at 1 year, p < 0.001. Mean antiglaucoma medications dropped from 2.95 (0.97) preoperatively to 1.23 (1.22) at month 12 (p < 0.001). Of the 21 eyes included in the study, 18 (85.7%) were considered as success, 6 (28.6%) as complete success, and 12 (57.1%) as qualified success. Five eyes required needling revision. Complications included uveitis, choroidal detachment, hyphema, and cystoid macular edema in 2, 1, 1, and 1 eye, respectively.
XEN45 Gel Stent implant significantly reduced the intraocular pressure and the number of antiglaucoma medications in patients with pseudoexfoliative glaucoma.
评估XEN45凝胶支架（爱尔兰都柏林艾尔建公司）对剥脱性青光眼患者的降眼压效果、安全性及成功率。
对接受XEN45植入手术并结膜下注射丝裂霉素C的剥脱性青光眼患者（无论有无白内障）进行回顾性研究，术后随访至少12个月。主要观察指标为术后1年与基线相比的眼压降低情况。完全成功定义为术后12个月眼压较术前基线降低⩾20%且无需任何青光眼药物治疗。合格成功定义为术后12个月使用药物治疗后眼压降低⩾20%。
24例筛查患者中，20例患者的21只眼符合纳入/排除标准并纳入研究。共13只眼（62%）接受了单纯XEN手术，8只眼（38%）接受了XEN联合白内障手术。平均眼压从基线时的21.1（3.8）mmHg显著降至1年时的15.2（3.9）mmHg，p<0.001。平均抗青光眼药物用量从术前的2.95（0.97）降至术后12个月时的1.23（1.22）（p<0.001）。研究纳入的21只眼中，18只眼（85.7%）被视为成功，6只眼（28.6%）为完全成功，12只眼（57.1%）为合格成功。5只眼需要针刺修复。并发症包括2只眼发生葡萄膜炎、1只眼发生脉络膜脱离、1只眼发生前房积血和1只眼发生黄斑囊样水肿。
XEN45凝胶支架植入术显著降低了剥脱性青光眼患者的眼压及抗青光眼药物用量。
