Abstract
Purpose :
To evaluate the surgical outcomes of XEN gel implant at 12-month follow-up, including post-operative intraocular pressure (IOP), glaucoma medications, rate of needling and secondary surgery intervention for 3 intraoperative MMC concentrations ranges
Methods :
Retrospective study of consecutive XEN gel implantation with MMC for treatment of glaucoma. Total MMC amount were divided into 3 ranges: ≤ 20mcg (n = 55), (20-40mcg] (not including 20mcg, n = 177) and >40mcg (n = 15). The change in intra-ocular pressure and number of glaucoma medications at 12 months were compared among the three MMC groups. The rate of needling and additional surgical interventions were also compared.
Results :
The three MMC groups had similar distribution of sex, glaucoma severity, visual acuity, pre-operative IOP, and number of glaucoma medications. There was a difference in the average patient age (P <0.01). XEN implantation was combined with phacoemulsification in 13.5% of patients in the ≤20mcg group, 22.7% in the 20-40mcg group, and 33.1% in the >40mcg group (P <0.05). There were no significant differences in rates of prior tube or trabeculectomy surgeries among the three groups. 50.6% of patients had follow-up at month 12.
At 1 year, the average IOP significantly decreased by 10.8 ±8.5mmHg (-38.4%, n=29) for the ≤20mcgm group, by 7.5 ±8.8mmHg (-26.3%, n=92) for the 20-40mcg group, and by 12.8 ±11.3mmHg (-55.5%, n=4) in the >40mcg group. The IOP change was not statistically different among the 3 groups (P =0.72). The average number of medications also decreased in all 3 groups, by -1.4 (-53.2%), -1.6 (-56.5%) and -1.8 (-46.7%), respectively. The rate of needling was 39.5% in the ≤20mcg group, 33.1% for the 20-40mcg group, and 22.2% in the >40mcg group (P=0.44). The rates of secondary surgeries were similar among the three groups, 10.26%, 15.34%, and 16.67%, respectively (P =0.69). Common adverse events included transient hypotony (n=74), choroidal effusion (n=13), bleb leaks (n =10) and hyphema (n =8).
Conclusions :
The total amount of MMC used intra-operatively during XEN gel implantation were grouped into 3 ranges: ≤ 20mcg, (20-40mcg] and >40mcg. At 1 year, there were no significant difference in post-op IOP change, glaucoma medication, needling rate, and rate of secondary surgeries when comparing among the three MMC groups.
This is a 2021 ARVO Annual Meeting abstract.