Ophthalmology, Hospital Universitario de Fuenlabrada, Madrid, Spain.
J Glaucoma. 2023 Jun 1;32(6):511-519. doi: 10.1097/IJG.0000000000002206. Epub 2023 Mar 7.
XEN gel stent and nonpenetrating deep sclerectomy, both either alone or in combination with cataract surgery, significantly lowered the intraocular pressure (IOP) and reduced the number of antiglaucoma medications in patients with open angle glaucoma, with no significant differences between them.
To compare the surgical outcomes of XEN45 implant and nonpenetrating deep sclerectomy (NPDS), either alone or in combination with cataract surgery, in patients with ocular hypertension and open angle glaucoma (OAG). A retrospective and single-center cohort study was conducted on consecutive patients who underwent a XEN45 implant or an NPDS, either alone or in combination with phacoemulsification. The primary endpoint was the mean change in IOP from the baseline to the last follow-up visit. One hundred twenty-eight eyes, 65 (50.8%) eyes in the NPDS group and 63 (49.2%) eyes in the XEN group, were included in the study. The mean preoperative IOP was significantly lowered from 17.6±5.3 mm Hg and 17.8±6.2 mm Hg to 12.6±2.6 mm Hg and 13.8±2.8 mm Hg at month 12 in the XEN and NPDS groups, respectively; P <0.0001 each. At month 12, 70 (54.7%) eyes were classified as a success, with no significant differences between XEN (57.1%; 36/63 eyes) and NPDS (52.3%; 34/65 eyes) (mean difference: 4.8%; 95% CI: -30.5% to 20.8%; P =0.7115). The number of ocular hypotensive medications was significantly reduced in the XEN (from 2.1±0.7-0.2±0.5, P <0.0001) and in the NPDS (from 2.0±0.8 to 0.3±0.6, P <0.0001) groups, with no significant differences between them ( P =0.2629). The incidence of postoperative adverse events in the overall study population was 12.5%, with no significant differences between groups ( P =0.1275). Seven (11.1%) eyes underwent needling (XEN group) and 10 (15.4%) goniopuncture (NPDS group); P =0.4753.
XEN45 implant and the NPDS, either alone or in combination with cataract surgery, significantly lowered IOP and reduced the number of ocular hypotensive medications in ocular hypertension and patients with open angle glaucoma.
XEN 凝胶支架和非穿透性深层巩膜切除术，单独或联合白内障手术，均显著降低了开角型青光眼患者的眼压（IOP）并减少了抗青光眼药物的使用次数，且两者之间无显著差异。
比较 XEN45 植入物和非穿透性深层巩膜切除术（NPDS），单独或联合白内障手术，在高眼压和开角型青光眼（OAG）患者中的手术效果。对连续接受 XEN45 植入物或 NPDS 治疗的患者进行回顾性单中心队列研究，单独或联合超声乳化术。主要终点是从基线到最后随访时 IOP 的平均变化。本研究共纳入 128 只眼，NPDS 组 65 只（50.8%）眼，XEN 组 63 只（49.2%）眼。术前平均眼压从 17.6±5.3mmHg 和 17.8±6.2mmHg 显著降低至 XEN 组和 NPDS 组的 12.6±2.6mmHg 和 13.8±2.8mmHg，均 P<0.0001。在第 12 个月，70 只（54.7%）眼被归类为成功，XEN 组（57.1%；36/63 只眼）和 NPDS 组（52.3%；34/65 只眼）之间无显著差异（平均差异：4.8%；95%CI：-30.5%至 20.8%；P=0.7115）。XEN 组（从 2.1±0.7 降至 0.2±0.5，P<0.0001）和 NPDS 组（从 2.0±0.8 降至 0.3±0.6，P<0.0001）中降眼压药物的数量均显著减少，两组之间无显著差异（P=0.2629）。在总体研究人群中，术后不良事件的发生率为 12.5%，组间无显著差异（P=0.1275）。7 只（11.1%）眼行针刺（XEN 组）和 10 只（15.4%）房角穿刺（NPDS 组）；P=0.4753。
XEN45 植入物和 NPDS，单独或联合白内障手术，均显著降低了眼压并减少了高眼压和开角型青光眼患者的降眼压药物的使用。
