Ophthalmology Department, Colchester Eye Centre of Excellence, East Suffolk and North Essex NHS Foundation Trust, Turner Road, Mile End, Colchester, CO4 5JR, ESSEX, UK.
Int Ophthalmol. 2022 Mar;42(3):881-889. doi: 10.1007/s10792-021-02069-5. Epub 2021 Oct 19.
To investigate the safety and efficacy of glaucoma XEN stent implantation and examine the effect of undergoing combined phacoemulsification and XEN versus XEN implant alone.
A retrospective case note review of patients who underwent XEN implantation by a single surgeon over a 24-month period was performed. Outcomes included changes in IOP and medication use after XEN implant insertion as well as complications post-surgery. Subgroup analysis was also performed, separating phaco-XEN (phacoemulsification and XEN implantation) and stand-alone XEN implantation.
186 XEN implant procedures were included in this study from a total of 143 patients. Intraocular pressure changes with time were as follows: preoperative 18.1 mmHg (± 5.77), 6 months 13.2 mmHg (SD ± 3.9), 12 months 13.7 mmHg (SD ± 5.6) and 24 months 12.6 mmHg (SD ± 3.1). For visits up to 12 months, comparison from preoperative IOP was significant at the < 0.0001 level; for 18 and 24 months, significance was < 0.05. Medication usage with time was as follows: preoperative 2.5 (SD ± 1.1) 6 months 0.7 (SD ± 0.9), 12 months 0.8 (SD ± 0.97), and 24 months 1.7 (SD ± 1.7). All results were significant at < 0.05 level. Subgroup analysis of separate phaco-XEN and stand-alone XEN groups did not reveal significant differences in IOP; however, there was a significant difference between the two groups preoperatively. Initial hypotony occurred in 75 cases (40%). There were 9 cases of hypotonous maculopathy, 3 cases of persistent choroidal effusions, 3 cases of IOP spikes, 1 cases of cyclodialysis cleft and 1 case of corneal decompensation. 25 (13%) cases had needling during their treatment.
The XEN implant appears to be safe and effective at reducing intraocular pressure and medication usage in glaucoma patients. XEN implantation is an effective treatment option for a range of glaucoma types and can be used as a stand-alone procedure or combined with cataract surgery to treat glaucoma patients.
研究青光眼 XEN 支架植入的安全性和有效性，并探讨行超声乳化白内障吸除术联合 XEN 植入与单纯 XEN 植入的效果。
对一位外科医生在 24 个月期间行 XEN 植入的患者进行回顾性病历审查。研究结果包括 XEN 植入后眼压和药物使用的变化以及手术后的并发症。还进行了亚组分析，将超声乳化白内障吸除术联合 XEN 植入（超声乳化白内障吸除术和 XEN 植入）与单纯 XEN 植入分开。
本研究共纳入了 143 名患者的 186 例 XEN 植入手术。眼压随时间的变化如下：术前 18.1mmHg（±5.77），术后 6 个月 13.2mmHg（SD±3.9），术后 12 个月 13.7mmHg（SD±5.6），术后 24 个月 12.6mmHg（SD±3.1）。对于随访至 12 个月的患者，术前与术后的比较具有统计学意义（<0.0001）；对于随访至 18 个月和 24 个月的患者，差异具有统计学意义（<0.05）。药物使用随时间的变化如下：术前 2.5（SD±1.1），术后 6 个月 0.7（SD±0.9），术后 12 个月 0.8（SD±0.97），术后 24 个月 1.7（SD±1.7）。所有结果均具有统计学意义（<0.05）。单独的超声乳化白内障吸除术联合 XEN 组和单纯 XEN 组的亚组分析显示，两组的眼压没有显著差异；然而，两组之间存在术前的显著差异。75 例（40%）患者发生早期低眼压。9 例出现低眼压性黄斑病变，3 例出现持续性脉络膜渗出，3 例出现眼压升高，1 例出现睫状体分离裂孔，1 例出现角膜失代偿。25 例（13%）患者在治疗过程中需要进行针刺。
XEN 植入似乎是安全且有效的，可降低青光眼患者的眼压和药物使用量。XEN 植入是治疗各种类型青光眼的有效治疗选择，可单独使用，也可与白内障手术联合使用，以治疗青光眼患者。
