{Reference Type}: Journal Article
{Title}: Long-term efficacy and safety of XEN-45 gel stent implantation in patients with normal-tension glaucoma.
{Author}: Nasyrov E;Gassel CJ;Merle DA;Neubauer J;Voykov B;
{Journal}: BMC Ophthalmol
{Volume}: 24
{Issue}: 1
{Year}: 2024 Jun 21
{Factor}: 2.086
{DOI}: 10.1186/s12886-024-03522-6
{Abstract}: <B>BACKGROUND: </B>Minimally invasive bleb surgery using the XEN-45 gel stent has not been established for the treatment of normal-tension glaucoma (NTG). The main objective of this study was to evaluate the long-term treatment efficacy and safety of XEN-45 in eyes with uncontrolled NTG.<BR><B>METHODS: </B>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.<BR><B>RESULTS: </B>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.<BR><B>CONCLUSIONS: </B>The XEN-45 stent is effective and safe for the long-term treatment of NTG. However, needling was frequently required to improve outcomes.