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Sachin Rajpal, Pavan Angadi, Leslie Stiff Jones; XEN Gel Stent Outcomes in an African American Population. Invest. Ophthalmol. Vis. Sci. 2018;59(9):2052.
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Studies investigating the XEN Gel Stent, a novel ab interno drainage device used for intraocular pressure lowering (IOP) in primary open angle glaucoma (POAG), do not adequately represent African American patients in their patient population. Our goal is to better represent our patient population, a predominantly African American demographic, as we believe that the results of previous studies may or may not be generalizable to our patient population at Howard University Hospital. We performed a retrospective, clinical review of patients who underwent XEN Gel Stent surgery to improve our understanding of the outcomes and adverse effects of the procedure in our patient population to guide us in future decision making in the treatment of POAG.
Ten patients who underwent combined cataract and XEN Gel Stent procedures and XEN Gel Stent alone performed at the HUH Department of Ophthalmology were reviewed. Ethnicity, sex and age demographics were recorded. Visual acuity, IOP, number of IOP lowering medications, and surgical complications were recorded for pre-operative and post operative day 1, week 1, 2, and 4. In addition we analyzed whether any additional procedures such as bleb needling were required.
The average pre-operative IOP was 17.6mmHg (95% CI 13.2-22.0) and the average post-operative IOP day 1 was 8.9mmHg (95% CI 7.23-10.57); week 1 was 9.7mmHg (95 % CI 7-12.4); week 2 was 12.4mmHg (95% CI 7.8-17); and week 4 was 10.6mmHg (95% CI 9.6-11.6) . The mean pre-operative vs post-operative number of IOP lowering medications was 3.0 vs 0.1 (P<0.001). 3 out of 10 patients required bleb needling with average pre and post needling IOP being 20.67 and 6.67 respectively (P>0.05). There were no other surgical complications or adverse events.
Our results show a trend towards the XEN Gel stent being an effective treatment for IOP lowering in our predominantly African American patient population at Howard University Hospital. We are cautiously optimistic that these trends will continue as we track our patients through a longer time period. It remains to be seen whether these trends will continue in a larger population study with a longer duration of post-operative evaluation.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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