Poelman Huub J, Pals Jan, Rostamzad Parinaz, Bramer Wichor M, Wolfs Roger C W, Ramdas Wishal D
Department of Ophthalmology, Erasmus MC, University Medical Center, 3000 CA Rotterdam, The Netherlands.
Medical Library, Erasmus MC, University Medical Center, 3000 CA Rotterdam, The Netherlands.
J Clin Med. 2021 Mar 7;10(5):1118. doi: 10.3390/jcm10051118.
To assess the efficacy of XEN-implant surgery in patients with glaucoma, and to perform a meta-analysis of previously published results and compare these to our data.
Prospective case-control study, in which all eyes that underwent XEN-implant surgery were included from 2015 onwards. Sub-analyses were performed for eyes that underwent XEN-implant as standalone procedure and as cataract-combined procedure. To compare our results, a systematic review was performed using the Embase, PubMed, Web of Science, and Cochrane database. Meta-analyses were performed by combining data (intraocular pressure (IOP), IOP-lowering medication, and complications) from the retrieved studies.
A total of 221 eyes underwent XEN-implant surgery (124 standalone and 97 cataract-combined). The mean ± standard deviation IOP declined from 18.8 ± 6.5 to 13.5 ± 4.3 mmHg at the last follow-up ( < 0.001; 28.9%). Postoperative, no significant differences in IOP or IOP-lowering medication were found between patients with and without combined procedure. Secondary surgeries were performed in 20.8% of eyes, most of them (63.0%) within six months. A meta-analysis of 19 studies retrieved from the systematic review showed a two-years postoperative pooled mean (weighted mean difference) of 14.5 (7.3) mmHg and 1.0 (1.6) for IOP and IOP-lowering medications, respectively (compared to 13.5 (5.3) mmHg and 3.2 (2.4) in the current study).
XEN-implant surgery was effective and safe in lowering IOP and the number of IOP-lowering medications. There were no differences between standalone and combined procedures.
评估XEN植入手术治疗青光眼患者的疗效，并对先前发表的结果进行荟萃分析，并将这些结果与我们的数据进行比较。
前瞻性病例对照研究，纳入自2015年起接受XEN植入手术的所有眼睛。对接受XEN植入作为单独手术和白内障联合手术的眼睛进行亚组分析。为了比较我们的结果，使用Embase、PubMed、Web of Science和Cochrane数据库进行了系统评价。通过合并检索到的研究中的数据（眼压（IOP）、降低眼压的药物和并发症）进行荟萃分析。
共有221只眼睛接受了XEN植入手术（124只单独手术，97只白内障联合手术）。在最后一次随访时，平均±标准差眼压从18.8±6.5 mmHg降至13.5±4.3 mmHg（<0.001；28.9%）。术后，联合手术和未联合手术的患者在眼压或降低眼压药物方面没有显著差异。20.8%的眼睛进行了二次手术，其中大部分（63.0%）在六个月内进行。对系统评价中检索到的19项研究进行的荟萃分析显示，术后两年的合并平均（加权平均差）眼压为14.5（7.3）mmHg，降低眼压药物为1.0（1.6）（与本研究中的13.5（5.3）mmHg和3.2（2.4）相比）。
XEN植入手术在降低眼压和降低眼压药物数量方面是有效且安全的。单独手术和联合手术之间没有差异。
