XEN‐45 collagen implant for the treatment of uveitic glaucoma

• Published in: Clinical & experimental ophthalmology Vol. 46; no. 4; pp. 339 - 345
• Main Authors: Sng, Chelvin CA, Wang, Jing, Hau, Scott, Htoon, Hla Myint, Barton, Keith
• Format: Journal Article
• Language: English
• Published: Melbourne John Wiley & Sons Australia, Ltd 01.05.2018; Wiley Subscription Services, Inc
• Subjects: Collagen; Complications; Eye surgery; Glaucoma; glaucoma surgery; Implantation; Intraocular pressure; minimally invasive glaucoma surgery; Ophthalmology; Patients; Surgery; uveitic glaucoma; glaucoma surgery; uveitic glaucoma; glaucoma; minimally invasive glaucoma surgery
• ISSN: 1442-6404; 1442-9071
• DOI: 10.1111/ceo.13087

Importance The XEN‐45 implant, a hydrophilic collagen implant which drains aqueous to the subconjunctival space, has not been investigated in the context of uveitic glaucoma. Background To determine the safety and efficacy of the XEN‐45 collagen implant in eyes with uveitic glaucoma. Design Exploratory prospective case series. Participants patients with medically uncontrolled uveitic glaucoma. Methods Twenty‐four consecutive patients (mean age ± standard deviation [SD] = 45.3 ± 18.1 years) were implanted with the XEN‐45 implant. Main Outcome Measures The primary outcome measure was intraocular pressure (IOP) reduction at 12 months as compared to baseline. Secondary outcome measures included ocular hypotensive medication use at 12 months, the requirement for further glaucoma surgery and failure. Intraoperative and postoperative complications were documented. Results The baseline mean ± SD IOP was 30.5 ± 9.8 mmHg and the mean ± SD number of glaucoma medications required was 3.3 ± 0.8. In 20 eyes (83.3%) in whom conventional glaucoma surgery was originally perceived to be inevitable, further surgery was not required after XEN‐45 implantation. The mean IOP was reduced by 60.2% from baseline to 12.2 ± 3.1 mmHg and mean medication usage was reduced to 0.4 ± 0.9 at 12 months (both P < 0.001). One patient had hypotony persisting beyond 2 months that required surgical revision and one patient developed blebitis. The 12‐month cumulative Kaplan–Meier survival probability was 79.2%. Conclusions and Relevance The XEN‐45 implant is effective for the treatment of patients with medically uncontrolled uveitic glaucoma. Potentially sight‐threatening complications, including bleb‐related ocular infection and persistent hypotony, may occur.