Purchase this article with an account.
Tina Xia, Ian P Conner, Evan Lagouros, David Rooney, Leonard Seibold, Julia Huecker, Arsham Sheybani; Intraoperative MMC concentrations and surgical outcomes in XEN gel implantation for glaucoma. Invest. Ophthalmol. Vis. Sci. 2021;62(8):3395.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
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
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.
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).
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.
Average IOP and change in IOP
Average medications and percent change
This PDF is available to Subscribers Only