June 2020
Volume 61, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2020
Long-Term Outcomes of Subconjunctival Gel Stent with and without Concomitant Cataract Surgery
Author Affiliations & Notes
  • Saami Zakaria
    Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • Christopher Ahmed
    Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • Nikki Angela Mehran
    Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • Sapna Sinha
    Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • Reza Razeghinejad
    Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • Jonathan S Myers
    Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • Marlene R Moster
    Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • Daniel Lee
    Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • Natasha Kolomeyer
    Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • Footnotes
    Commercial Relationships   Saami Zakaria, None; Christopher Ahmed, None; Nikki Mehran, None; Sapna Sinha, None; Reza Razeghinejad, None; Jonathan Myers, Aerie (C), Aerie (R), Allergan (C), Allergan (F), Allergan (R), Glaukos (C), Glaukos (F), MicroOptx (C); Marlene Moster, None; Daniel Lee, Allergan (C), Allergan (F); Natasha Kolomeyer, Spouse - Allergan (C)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2020, Vol.61, 947. doi:
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      Saami Zakaria, Christopher Ahmed, Nikki Angela Mehran, Sapna Sinha, Reza Razeghinejad, Jonathan S Myers, Marlene R Moster, Daniel Lee, Natasha Kolomeyer; Long-Term Outcomes of Subconjunctival Gel Stent with and without Concomitant Cataract Surgery. Invest. Ophthalmol. Vis. Sci. 2020;61(7):947.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : We performed a retrospective, observational clinical study to evaluate the one year outcomes of the subconjunctival gel microstent (XEN45, Allergan) in glaucoma patients with and without combined cataract surgery.

Methods : Retrospective analysis of patients that received a XEN45 implant for medically uncontrolled glaucoma at a tertiary care center between January 2017-December 2018 was conducted. Demographics, intraocular pressure (IOP), anti-glaucoma medications (AGM), needling, and subsequent glaucoma surgeries were noted. Success was defined as IOP reduction > 20% from baseline and IOP < 18 mm Hg with (qualified success) or without (complete success) glaucoma medication. Subjects receiving additional surgery besides needling/revisions at any point prior to examination intervals were censored, counted as failures, and noted as having subsequent surgeries. Patients with/without combined cataract surgery at the time of stent implantation were also compared.

Results : 162 eyes met inclusion criteria (mean age 74, 59% female, 73% white). Mean preop IOP was 24.3 mm Hg (95% CI, 23.0, 25.6). Mean change in IOP was -9.0 (-7.4,-10.7), and -8.4 (-6.8,-9.9), at 6, and 12 months (m, p< .0001 for all). Mean AGM was 3.0 (2.9,3.2) at baseline and 1.2 (1.0, 1.5) at 12m follow up (p<.0001). 44 (27%) eyes required needling. 33 (20%) eyes required subsequent glaucoma surgery within 12m (15% repeat XEN implants, 39% trabeculectomies, 46% tube shunts). 53% and 31% of eyes met criteria for qualified and complete success at 12m. Patients that had combined cataract surgery (N=31) had less IOP reduction (15%) than pseudophakic (N=68) and phakic patients (N=63) (39% and 38%, respectively, p= .001).

Conclusions : This study highlights significant IOP and medication reductions with gel stent implantation. 20% of patients required a subsequent glaucoma surgery, beyond needling or revision, within a 12 month period. Concomitant cataract surgery was associated with less IOP reduction. These findings warrant further study.

This is a 2020 ARVO Annual Meeting abstract.

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