Abstract：
OBJECTIVE: To evaluate the effectiveness and safety of the XEN-Stent for managing unresponsive to medical therapy secondary glaucoma after silicone oil (SO) removal.
METHODS: This retrospective chart reviewed 12 patients who underwent vitrectomy and SO endotamponade. They experienced intraocular pressure (IOP) elevation after SO removal despite taking the maximum tolerated glaucoma medication. Eleven eyes underwent an XEN-implant, while 1 underwent an XEN-implant with phacoemulsification/IOL implantation. The primary outcome was to achieve success criteria: IOP <18 mmHg and >20% IOP reduction without medication (complete success) or with medication (qualified success) and without a secondary IOP-lowering procedure. IOP, best-corrected visual acuity (BCVA), and the number of glaucoma medications (Glaucoma Medication Score-GMS) were recorded at baseline, 1 day, 1 week, 1 (M1), 3 (M3), 6 (M6), and 12 (M12) months postoperatively.
RESULTS: Baseline characteristics included males percentage 66.6%, mean age of 61.8 ± 5.7 years, BCVA 0.69 ± 0.3 logMAR, IOP 30 ± 4.2 mmHg, and GMS 3.1 ± 0.5. There was a significant reduction in IOP by 14 ± 1.9 mmHg and GMS by 0.27 ± 0.6 at M12 compared to baseline (p < 0.01), but no significant change in BCVA (p = 0.21). Complete success dropped to 50% (M3), rising to 75% (M6, M12) after needling. Two patients achieved qualified success at M12. Needling was performed in 6 eyes, with 3 requiring a second procedure. Ex-PRESS was required in 1 eye. One eye experienced hypotony and hyphema, which resolved within a week.
CONCLUSIONS: XEN implant may be an initial treatment for persistent post SO removal glaucoma with minimal complications. Needling procedures can help maintain or restore surgical success.
METHODS: This retrospective chart reviewed 12 patients who underwent vitrectomy and SO endotamponade. They experienced intraocular pressure (IOP) elevation after SO removal despite taking the maximum tolerated glaucoma medication. Eleven eyes underwent an XEN-implant, while 1 underwent an XEN-implant with phacoemulsification/IOL implantation. The primary outcome was to achieve success criteria: IOP <18 mmHg and >20% IOP reduction without medication (complete success) or with medication (qualified success) and without a secondary IOP-lowering procedure. IOP, best-corrected visual acuity (BCVA), and the number of glaucoma medications (Glaucoma Medication Score-GMS) were recorded at baseline, 1 day, 1 week, 1 (M1), 3 (M3), 6 (M6), and 12 (M12) months postoperatively.
RESULTS: Baseline characteristics included males percentage 66.6%, mean age of 61.8 ± 5.7 years, BCVA 0.69 ± 0.3 logMAR, IOP 30 ± 4.2 mmHg, and GMS 3.1 ± 0.5. There was a significant reduction in IOP by 14 ± 1.9 mmHg and GMS by 0.27 ± 0.6 at M12 compared to baseline (p < 0.01), but no significant change in BCVA (p = 0.21). Complete success dropped to 50% (M3), rising to 75% (M6, M12) after needling. Two patients achieved qualified success at M12. Needling was performed in 6 eyes, with 3 requiring a second procedure. Ex-PRESS was required in 1 eye. One eye experienced hypotony and hyphema, which resolved within a week.
CONCLUSIONS: XEN implant may be an initial treatment for persistent post SO removal glaucoma with minimal complications. Needling procedures can help maintain or restore surgical success.
摘要：
目的：评估XEN支架治疗硅油（SO）去除后对药物治疗继发性青光眼无反应的有效性和安全性。
方法：本回顾性图表回顾了12例接受玻璃体切割和SO内填充的患者。尽管服用了最大耐受的青光眼药物，但在去除SO后，他们的眼内压（IOP）升高。11只眼睛接受了XEN植入，1例接受了超声乳化/人工晶状体植入的XEN植入。主要结果是达到成功标准：IOP<18mmHg和IOP降低>20％，无需药物治疗（完全成功）或药物治疗（合格成功）且无需二次降低IOP程序。IOP,最佳矫正视力（BCVA），和青光眼药物的数量（青光眼药物评分-GMS）记录在基线，1天,1周,1(M1),3(M3),6(M6),术后12(M12)个月。
结果：基线特征包括男性占66.6%，平均年龄61.8±5.7岁，BCVA0.69±0.3logMAR,眼压30±4.2mmHg,和GMS3.1±0.5。与基线相比，M12时IOP显著降低14±1.9mmHg，GMS显著降低0.27±0.6(p<0.01)，但BCVA无显著变化(p=0.21)。完全成功率下降到50%(M3),针刺后上升到75%（M6，M12）。两名患者在M12时获得了合格的成功。在6只眼睛中进行了针刺，3需要第二个程序。1只眼睛需要Ex-PRESS。一只眼睛出现了低眼压和前房积血,在一周内解决。
结论：XEN植入可能是持续性SO去除后青光眼的初始治疗方法，并发症最少。针刺程序可以帮助维持或恢复手术成功。
方法：本回顾性图表回顾了12例接受玻璃体切割和SO内填充的患者。尽管服用了最大耐受的青光眼药物，但在去除SO后，他们的眼内压（IOP）升高。11只眼睛接受了XEN植入，1例接受了超声乳化/人工晶状体植入的XEN植入。主要结果是达到成功标准：IOP<18mmHg和IOP降低>20％，无需药物治疗（完全成功）或药物治疗（合格成功）且无需二次降低IOP程序。IOP,最佳矫正视力（BCVA），和青光眼药物的数量（青光眼药物评分-GMS）记录在基线，1天,1周,1(M1),3(M3),6(M6),术后12(M12)个月。
结果：基线特征包括男性占66.6%，平均年龄61.8±5.7岁，BCVA0.69±0.3logMAR,眼压30±4.2mmHg,和GMS3.1±0.5。与基线相比，M12时IOP显著降低14±1.9mmHg，GMS显著降低0.27±0.6(p<0.01)，但BCVA无显著变化(p=0.21)。完全成功率下降到50%(M3),针刺后上升到75%（M6，M12）。两名患者在M12时获得了合格的成功。在6只眼睛中进行了针刺，3需要第二个程序。1只眼睛需要Ex-PRESS。一只眼睛出现了低眼压和前房积血,在一周内解决。
结论：XEN植入可能是持续性SO去除后青光眼的初始治疗方法，并发症最少。针刺程序可以帮助维持或恢复手术成功。
