XEN‐45 collagen implant for the treatment of uveitic glaucoma
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 Explorat...
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Published in | Clinical & experimental ophthalmology Vol. 46; no. 4; pp. 339 - 345 |
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Main Authors | , , , , |
Format | Journal Article |
Language | English |
Published |
Melbourne
John Wiley & Sons Australia, Ltd
01.05.2018
Wiley Subscription Services, Inc |
Subjects | |
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Abstract | 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. |
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AbstractList | IMPORTANCEThe XEN-45 implant, a hydrophilic collagen implant which drains aqueous to the subconjunctival space, has not been investigated in the context of uveitic glaucoma.BACKGROUNDTo determine the safety and efficacy of the XEN-45 collagen implant in eyes with uveitic glaucoma.DESIGNExploratory prospective case series.PARTICIPANTSpatients with medically uncontrolled uveitic glaucoma.METHODSTwenty-four consecutive patients (mean age ± standard deviation [SD] = 45.3 ± 18.1 years) were implanted with the XEN-45 implant.MAIN OUTCOME MEASURESThe 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.RESULTSThe 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 RELEVANCEThe 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. 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. To determine the safety and efficacy of the XEN-45 collagen implant in eyes with uveitic glaucoma. Exploratory prospective case series. patients with medically uncontrolled uveitic glaucoma. Twenty-four consecutive patients (mean age ± standard deviation [SD] = 45.3 ± 18.1 years) were implanted with the XEN-45 implant. 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. 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%. 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. 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. Abstract 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. |
Author | Htoon, Hla Myint Hau, Scott Wang, Jing Sng, Chelvin CA Barton, Keith |
Author_xml | – sequence: 1 givenname: Chelvin CA orcidid: 0000-0002-9837-6019 surname: Sng fullname: Sng, Chelvin CA email: chelvin@gmail.com organization: Singapore Eye Research Institute – sequence: 2 givenname: Jing surname: Wang fullname: Wang, Jing organization: Moorfields Eye Hospital – sequence: 3 givenname: Scott surname: Hau fullname: Hau, Scott organization: Moorfields Eye Hospital – sequence: 4 givenname: Hla Myint surname: Htoon fullname: Htoon, Hla Myint organization: Singapore Eye Research Institute – sequence: 5 givenname: Keith surname: Barton fullname: Barton, Keith organization: University College |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/29053204$$D View this record in MEDLINE/PubMed |
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The XEN‐45 implant, a hydrophilic collagen implant which drains aqueous to the subconjunctival space, has not been investigated in the context of... The XEN-45 implant, a hydrophilic collagen implant which drains aqueous to the subconjunctival space, has not been investigated in the context of uveitic... Abstract Importance The XEN‐45 implant, a hydrophilic collagen implant which drains aqueous to the subconjunctival space, has not been investigated in the... ImportanceThe XEN‐45 implant, a hydrophilic collagen implant which drains aqueous to the subconjunctival space, has not been investigated in the context of... IMPORTANCEThe XEN-45 implant, a hydrophilic collagen implant which drains aqueous to the subconjunctival space, has not been investigated in the context of... |
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SubjectTerms | Collagen Complications Eye surgery Glaucoma glaucoma surgery Implantation Intraocular pressure minimally invasive glaucoma surgery Ophthalmology Patients Surgery uveitic glaucoma |
Title | XEN‐45 collagen implant for the treatment of uveitic glaucoma |
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