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16.05.2019 | Glaucoma

XEN implant device versus trabeculectomy, either alone or in combination with phacoemulsification, in open-angle glaucoma patients

Zeitschrift:
Graefe's Archive for Clinical and Experimental Ophthalmology
Autoren:
María Teresa Marcos Parra, Javier Alejandro Salinas López, Noelia Soledad López Grau, Ana María Ceausescu, Juan José Pérez Santonja
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Abstract

Purpose

To compare the efficacy and safety of the XEN45 implant with that of trabeculectomy (TRAB), either alone or in combination with phacoemulsification (PHACO), in patients with open-angle glaucoma (OAG).

Methods

Retrospective, single-center and comparative study conducted on OAG patients. Patients were divided into four groups: group 1 (XEN alone); group 2 (XEN+PHACO); group 3 (TRAB alone); group 4 (TRAB+PHACO). For statistical purposes, groups 1 and 2 were combined (XEN implant), while groups 3 and 4 were also combined (TRAB surgery). The main outcome measure was intraocular pressure (IOP).

Results

Ninety-one patients (121 eyes; 65 XEN and 56 TRAB) were included. IOP reduction was − 6.7 (− 10.4 to − 3.0) mmHg, p = 0.0013; − 3.5 (− 5.0 to − 2.0) mmHg, p < 0.0001; − 8.1 (− 10.4 to − 5.9) mmHg, p < 0.0001l; and − 7.3 (− 9.3 to − 5.3) mmHg, p < 0.0001 in the XEN alone, XEN+PHACO, TRAB alone, and TRAB+PHACO, respectively. At month 12, an IOP ≥ 6 and ≤ 16 mm without treatment was achieved by 44 (67.7%) and 43 (76.8%), p = 0.2687 in the XEN implant and the TRAB surgery groups, respectively. The mean number of antiglaucoma medications was significantly reduced in all the study groups (p < 0.0001 each). Needling occurred in 20.0% (13/65) of eyes in the XEN implant group, while hyphema occurred in 30.4% (17/56) of eyes in the TRAB group.

Conclusions

XEN implant, either alone or in combination with phacoemulsification, significantly reduces both IOP and the number of antiglaucoma medications to a similar rate than trabeculectomy, but with a better safety profile.

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Literatur
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