Abstract：
To compare trabeculectomy with mitomycin C (trab-MMC) and XEN45 Gel Stent placed ab externo with open conjunctiva (XGS AEO) with or without cataract surgery in patients with glaucoma.
Nonrandomized, retrospective, comparative study.
A total of 204 eyes from 204 glaucoma patients who received XGS AEO or underwent trab-MMC with or without cataract surgery between July 2018 and August 2021 at Massachusetts Eye and Ear.
Visits from 204 patient charts were reviewed after either trab-MMC or XGS AEO from 2018 to 2021 from a level 3 triage center.
Intraocular pressure (IOP), medication burden, Kaplan-Meier success rates, 5-fluorouracil impact, and complications.
One hundred fifty-seven patients underwent trab-MMC and 47 underwent XGS AEO. Groups had similar baseline intraocular pressure (IOP) and medications (meds). Intraocular pressure and meds decreased similarly at 1.5 years (11.2 mmHg vs. 7.4 mmHg, P = 0.62; 2.9 vs. 2.8 meds, P = 0.92, respectively for trab-MMC and XGS AEO). Success was defined as IOP reduction ≥ 20% with 5 mmHg ≤ IOP ≤ 18 mmHg for 2 consecutive visits. Complete success (CS) did not allow meds; qualified success (QS) allowed for ≤ baseline meds. When IOP fluctuations in the first 60 days were not counted as failures, CS was 43% for trab-MMC, about 8.5% higher than for XGS AEO (P < 0.01). Qualified success was similar between the groups (65%-67%). Procedure time was shorter for XGS AEO than trab-MMC (44 vs. 63 minutes, P < 0.01).
XEN45 Gel Stent AEO may provide similar benefits to trab-MMC, especially for patients who tolerate some meds, with shorter procedure times.
Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
Nonrandomized, retrospective, comparative study.
A total of 204 eyes from 204 glaucoma patients who received XGS AEO or underwent trab-MMC with or without cataract surgery between July 2018 and August 2021 at Massachusetts Eye and Ear.
Visits from 204 patient charts were reviewed after either trab-MMC or XGS AEO from 2018 to 2021 from a level 3 triage center.
Intraocular pressure (IOP), medication burden, Kaplan-Meier success rates, 5-fluorouracil impact, and complications.
One hundred fifty-seven patients underwent trab-MMC and 47 underwent XGS AEO. Groups had similar baseline intraocular pressure (IOP) and medications (meds). Intraocular pressure and meds decreased similarly at 1.5 years (11.2 mmHg vs. 7.4 mmHg, P = 0.62; 2.9 vs. 2.8 meds, P = 0.92, respectively for trab-MMC and XGS AEO). Success was defined as IOP reduction ≥ 20% with 5 mmHg ≤ IOP ≤ 18 mmHg for 2 consecutive visits. Complete success (CS) did not allow meds; qualified success (QS) allowed for ≤ baseline meds. When IOP fluctuations in the first 60 days were not counted as failures, CS was 43% for trab-MMC, about 8.5% higher than for XGS AEO (P < 0.01). Qualified success was similar between the groups (65%-67%). Procedure time was shorter for XGS AEO than trab-MMC (44 vs. 63 minutes, P < 0.01).
XEN45 Gel Stent AEO may provide similar benefits to trab-MMC, especially for patients who tolerate some meds, with shorter procedure times.
Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
摘要：
目的：比较小梁切除术与丝裂霉素C（trab-MMC）和XEN®45凝胶支架放置在开放结膜（XGSAEO）外，伴或不伴白内障手术的青光眼患者。
方法：非随机，回顾性比较研究。
方法：在2018年7月至2021年8月期间，来自204例接受XGS的青光眼患者的204只眼在马萨诸塞州眼和耳部接受AEO或接受了有或没有白内障手术的trab-MMC。
方法：根据trab-MMC或XGSAEO从2018年至2021年从3级分诊中心对204例患者的就诊进行了回顾。
方法：眼内压（IOP），药物负担,Kaplan-Meier成功率,5-氟尿嘧啶的影响，和并发症。
结果：157例患者接受了trab-MMC，47例接受了XGSAEO。各组具有相似的基线眼内压（IOP）和药物（药物）。眼压和药物在1.5年时类似地下降(11.2mmHg对7.4mmHg,p=0.62；2.9对2.8药物，p=0.92，分别为trab-MMC和XGSAEO）。成功定义为连续2次就诊的IOP降低≥20%，5mmHg≤IOP≤18mmHg。完全成功（CS）不允许用药；合格成功（QS）允许≤基线药物。当前60天的IOP波动不计入故障时,trab-MMC的CS为43%，比XGSAEO高约8.5%(p<0.01)。两组之间的QS相似（65-67％）。XGSAEO的手术时间短于trab-MMC（44vs63分钟，p<0.01)。
结论：XGSAEO可能提供与trab-MMC类似的益处，尤其是对一些药物耐受的病人,更短的程序时间。
方法：非随机，回顾性比较研究。
方法：在2018年7月至2021年8月期间，来自204例接受XGS的青光眼患者的204只眼在马萨诸塞州眼和耳部接受AEO或接受了有或没有白内障手术的trab-MMC。
方法：根据trab-MMC或XGSAEO从2018年至2021年从3级分诊中心对204例患者的就诊进行了回顾。
方法：眼内压（IOP），药物负担,Kaplan-Meier成功率,5-氟尿嘧啶的影响，和并发症。
结果：157例患者接受了trab-MMC，47例接受了XGSAEO。各组具有相似的基线眼内压（IOP）和药物（药物）。眼压和药物在1.5年时类似地下降(11.2mmHg对7.4mmHg,p=0.62；2.9对2.8药物，p=0.92，分别为trab-MMC和XGSAEO）。成功定义为连续2次就诊的IOP降低≥20%，5mmHg≤IOP≤18mmHg。完全成功（CS）不允许用药；合格成功（QS）允许≤基线药物。当前60天的IOP波动不计入故障时,trab-MMC的CS为43%，比XGSAEO高约8.5%(p<0.01)。两组之间的QS相似（65-67％）。XGSAEO的手术时间短于trab-MMC（44vs63分钟，p<0.01)。
结论：XGSAEO可能提供与trab-MMC类似的益处，尤其是对一些药物耐受的病人,更短的程序时间。
