Outcomes of Subconjunctival Gel Microstent Implantation: Age and Gender Analysis

Abstract

Purpose : We performed a retrospective, observational clinical study to evaluate the effect of patient demographics (age, gender) on surgical outcomes of subconjunctival gelatin stent (XEN45) in glaucoma patients.

Methods : Retrospective analysis of patients who received a XEN45 implant for medically uncontrolled glaucoma at a tertiary care center between January 2017-December 2018 was conducted. Demographic data, intraocular pressure (IOP), anti-glaucoma medications (AGM), needling, and subsequent non-needling glaucoma surgeries were noted for each patient. Outcomes were examined at 6 and 12 months (m) postoperatively. Success was defined as having no subsequent glaucoma surgery, IOP < 18 and IOP reduction of >20% from pre-op, with (qualified success) or without (complete success) anti-glaucoma medications (AGM). Advanced patient age was defined as >84 years.

Results : 162 eyes met inclusion criteria (mean age 74, 59% female, 17% >84 years). Qualified/complete success was 53%/31% at 12m using the stringent success criteria. 27% and 20% required needling or subsequent glaucoma surgery, respectively. Mean IOP was 24.3 ± 8.2 at baseline and 15.9 ± 4.3 at 12m. Mean number of AGM was 3.0 ± 1.1 at baseline, and 1.2 ± 1.4 at 12m. Lower rates of subsequent surgery (14% vs. 22%) and needling (14% vs. 30%) were observed for patients aged >84, but this was not statistically significant. Men had a greater rate of subsequent surgery (29% vs. 15%, p=0.029). We did not identify significant differences in IOP reduction or success by gender or age cohort.

Conclusions : Demographics assessed were not associated with surgical outcomes, with the exception of gender. Males had a higher rate of additional surgery. Needling/additional surgery rates were lower in the advanced age group, although not statistically significant. Further research is warranted to better understand the effect of demographics on XEN outcomes.

This is a 2020 ARVO Annual Meeting abstract.