Minimally invasive combined glaucoma and cataract surgery: clinical results of the smallest ab interno gel stent

• Published in: International ophthalmology Vol. 38; no. 3; pp. 1129 - 1134
• Main Authors: De Gregorio, Alessandra, Pedrotti, Emilio, Russo, Luisa, Morselli, Simonetta
• Format: Journal Article
• Language: English
• Published: Dordrecht Springer Netherlands 01.06.2018; Springer Nature B.V
• Subjects: Cataracts; Complications; Drugs; Eye surgery; Glaucoma; Implantation; Implants; Intraocular pressure; Medicine; Medicine & Public Health; Ophthalmology; Original Paper; Patients; Reduction; Stents; Success; Surgery; Surgical implants; Glaucoma; Filtration surgery; XEN Gel Stent; Microincisional glaucoma surgery (MIGS)
• ISSN: 0165-5701; 1573-2630; 1573-2630
• DOI: 10.1007/s10792-017-0571-x

Purpose To verify the efficacy in intraocular pressure (IOP) reduction and safety of the smallest gel stent (XEN 45 Gel Stent) microincisional glaucoma surgery combined with microincisional cataract surgery (MICS). Methods Nonrandomized prospective clinical study. Forty-one eyes of 33 patients with open-angle glaucoma underwent a XEN 45 Gel Stent implantation combined with MICS. Treatment outcomes analyzed included: IOP, medication use, intra- and postoperative complications. At the end of the follow-up, we evaluated the complete success, defined as a postoperative IOP ≥ 6 and ≤17 mmHg without glaucoma medications and the qualified success defined as a postoperative IOP ≥ 6 and ≤17 mmHg, with glaucoma medications. Results The mean preoperative IOP was 22.5 ± 3.7 mmHg on 2.5 ± 0.9 medication classes. After 12 months, the mean postoperative IOP was 13.1 ± 2.4 mmHg (mean IOP reduction of 41.82%) with a mean of 0.4 ± 0.8 medication classes ( P  < 0.05 for IOP and medications). The complete success rate was achieved in 80.4% and a qualified success in 97.5%. There were no major intra- and postoperative complications during the first year of follow-up. Conclusions This study demonstrated that the smaller diameter XEN 45 gel implant is statistically effective in reducing IOP and medications in glaucoma patients with a low rate of complications.