METHODS: A retrospective analysis of patients with NTG who underwent XEN-45 gel stent implantation at university hospital Tuebingen between 2016 and 2021. The primary outcome measure was surgical success after three years defined as lowering of intraocular pressure (IOP) of ≥ 20%, with target IOP between 6 and 15 mmHg. Success was complete without and qualified irrespective of topical antiglaucoma medication use. The need for further glaucoma surgery, except for needling, was regarded as a failure. The secondary outcome measures included changes in mean IOP, number of antiglaucoma medications, and needling and complication rates.
RESULTS: Twenty-eight eyes from 23 patients were included in the final analysis. Complete and qualified success rates were 56.5% and 75% after three years, respectively. Mean postoperative IOP ± standard deviation decreased significantly after three years from 19.3 ± 2.0 mmHg at baseline to 13.7 ± 4.2 mmHg (n = 22; p < 0.0001). The median number of antiglaucoma medications decreased from 2 (range 0-4) to 0 after three years (range 0-3; p < 0.0001). Sixteen eyes (57%) required a median of 1 (range 1-3) needling procedures. One eye required further glaucoma surgery. No sight-threatening complications were observed.
CONCLUSIONS: The XEN-45 stent is effective and safe for the long-term treatment of NTG. However, needling was frequently required to improve outcomes.
方法:回顾性分析2016年至2021年在Tuebingen大学医院接受XEN-45凝胶支架植入术的NTG患者。主要结果指标是手术成功三年后定义为眼内压(IOP)降低≥20%,目标IOP在6和15mmHg之间。无论使用局部抗青光眼药物,成功都是完全的,并且是合格的。需要进一步的青光眼手术,除了针刺,被视为失败。次要结果指标包括平均IOP的变化,抗青光眼药物的数量,针刺和并发症的发生率。
结果:23例患者的28只眼纳入最终分析。三年后,完全和合格的成功率分别为56.5%和75%,分别。术后平均眼压±标准差在三年后从基线时的19.3±2.0mmHg显著下降至13.7±4.2mmHg(n=22;p<0.0001)。抗青光眼药物的中位数量在三年后从2(范围0-4)降至0(范围0-3;p<0.0001)。16只眼睛(57%)需要中位数为1(范围1-3)的针刺程序。一只眼睛需要进一步的青光眼手术。未观察到危及视力的并发症。
结论:XEN-45支架对于NTG的长期治疗是有效和安全的。然而,经常需要针刺来改善结果.