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评估XEN微支架的一年疗效:不受部位变异性影响。

Assessing XEN microstent's one-year efficacy: independent of site variability.

作者信息

Bormann Caroline, Busch Catharina, Rehak Matus, Scharenberg Christian Thomas, Ziemssen Focke, Unterlauft Jan Darius

机构信息

Department of Ophthalmology, University of Leipzig, Liebigstrasse 10-14, Leipzig 04103, Germany.

Department of Ophthalmology, University of Innsbruck, Anichstraße 35, Innsbruck 6020, Austria.

出版信息

Int J Ophthalmol. 2025 Jan 18;18(1):86-93. doi: 10.18240/ijo.2025.01.10. eCollection 2025.

Abstract

AIM

To evaluate the short-term efficacy of XEN45 Gel Stent (XEN) implantation for primary open angle glaucoma (POAG) and pseudoexfoliation (PEX) glaucoma across two university eye clinics, aiming to assess the impact of varying center-specific protocols during the first postoperative year.

METHODS

We retrospectively examined 282 patients (183 in center 1, 99 in center 2), who underwent XEN microstent implantation for uncontrolled POAG or PEX glaucoma. Parameters including intraocular pressure (IOP), IOP-lowering medication count, best corrected visual acuity (BCVA), and postoperative complications were evaluated over 12mo.

RESULTS

Post-implantation, center 1 reported a mean IOP reduction from 25.3±7.4 to 14.1±4.7 mm Hg (<0.01) and a decrease in IOP-lowering medications from 3.2±1.2 to 1.0±1.3 (<0.01). Center 2 observed a similar reduction from 24.4±6.5 to 15.1±5.5 mm Hg (<0.01) and medication decrease from 3.0±1.1 to 1.2±1.0 (<0.01). BCVA remained stable in both cohorts. The most common complications were hypotony (center 1: 32; center 2: 20) and choroidal detachment (center 1: 22, center 2: 15), with nearly identical needling rates (40% in center 1, 41% in center 2).

CONCLUSION

XEN implantation yields consistent reductions in IOP and medication use across different centers using comparable surgical and postoperative treatment regime. These findings underscore XEN's short-term effectiveness and suggest standardizable outcomes regardless of exact surgical procedure or treatment differences.

摘要

目的

评估XEN45凝胶支架(XEN)植入术治疗原发性开角型青光眼(POAG)和剥脱性(PEX)青光眼的短期疗效,这是在两家大学眼科诊所进行的研究,旨在评估术后第一年不同中心特定方案的影响。

方法

我们回顾性研究了282例患者(中心1有183例,中心2有99例),这些患者因POAG或PEX青光眼控制不佳而接受了XEN微支架植入术。在12个月内评估了包括眼压(IOP)、降眼压药物数量、最佳矫正视力(BCVA)和术后并发症等参数。

结果

植入后,中心1报告平均眼压从25.3±7.4降至14.1±4.7 mmHg(P<0.01),降眼压药物从3.2±1.2减少至1.0±1.3(P<0.01)。中心2观察到类似的降低,从24.4±6.5降至15.1±5.5 mmHg(P<0.01),药物减少从3.0±1.1降至1.2±1.0(P<0.01)。两个队列的BCVA均保持稳定。最常见的并发症是低眼压(中心1:32例;中心2:20例)和脉络膜脱离(中心1:22例,中心2:15例),针刺率几乎相同(中心1为40%,中心2为41%)。

结论

使用可比的手术和术后治疗方案,XEN植入术在不同中心均可使眼压和药物使用持续降低。这些发现强调了XEN的短期有效性,并表明无论确切的手术程序或治疗差异如何,结果都具有可标准化性。

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本文引用的文献

1
Intraocular Pressure and Medication Changes Associated with Xen Gel Stent: A Systematic Review of the Literature.
Clin Ophthalmol. 2023 Jan 5;17:25-46. doi: 10.2147/OPTH.S390955. eCollection 2023.
2
Trabeculectomy versus Xen gel implant for the treatment of open-angle glaucoma: a 3-year retrospective analysis.
BMJ Open Ophthalmol. 2022 Jan 4;7(1):e000830. doi: 10.1136/bmjophth-2021-000830. eCollection 2022.
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JAMA. 2021 Jan 12;325(2):164-174. doi: 10.1001/jama.2020.21899.
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Outcome of a single XEN microstent implant for glaucoma patients with different types of glaucoma.
BMC Ophthalmol. 2020 Dec 17;20(1):490. doi: 10.1186/s12886-020-01764-8.
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Combined and stand-alone XEN 45 gel stent implantation: 3-year outcomes and success predictors.
Acta Ophthalmol. 2021 Jun;99(4):e531-e539. doi: 10.1111/aos.14605. Epub 2020 Sep 15.
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Two-Year Outcomes of XEN Gel Stent Surgery in Patients with Open-Angle Glaucoma.
Ophthalmol Glaucoma. 2019 Sep-Oct;2(5):309-318. doi: 10.1016/j.ogla.2019.03.011. Epub 2019 Jun 8.
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The Diagnosis and Treatment of Glaucoma.
Dtsch Arztebl Int. 2020 Mar 27;117(13):225-234. doi: 10.3238/arztebl.2020.0225.

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