Abstract
Purpose :
This study aims to determine the clinical efficacy of performing multiple Xen stent implantations in patients with POAG as determined by intraocular pressure (IOP) reduction and number of IOP-lowering medications needed after surgery.
Methods :
17 subjects (20 eyes) underwent multiple small-incision sub-Tenon ab interno Xen implantation procedures during a period from 2017 to 2022. Outcome measures monitored were IOP and current number of IOP-lowering medications. Data was taken at the preoperative appointment before each Xen implantation and again at all subsequent post-operative appointments. IOP was attained via Goldman applanation tonometry (GAT). All IOP measurements and procedures were performed by a single surgeon.
Results :
Average study participant age was 76.66±9.64 years. At preoperative visits mean IOP was 21.02±8.08mmHg. No eyes recorded an IOP of lower than 10mmHg, 6% recorded an IOP ≤12mmHg, 17% of eyes recorded an IOP ≤15mmHg, 36% recorded an IOP of lower than 17mmHg, and 57% of patients recorded an IOP of 20mmHg or higher. At postoperative visits, mean IOP was 12.37±3.56mmHg. All eyes had an IOP under 20mmHg, 89% of eyes recorded an IOP of 17 or lower, 84% recorded an IOP of 15 or lower, 53% recorded an IOP of 12 or lower, and 26% recorded an IOP of 10 or lower. At preoperative visits, 47% of patients were on 2 or fewer IOP-lowering medications, with an average of 2.53±1.41. At most recent postoperative appointments, 84% of patients were on 2 or fewer medications, with an average of 1.89±1.97. Patients most recent visits ranged from 5-49 months with the mean being 22.5±13.94 months.
Conclusions :
IOP-lowering effects were still seen for an average of 22.5 months after most recent Xen implantation. After initial ab interno Xen failure, repeating sub-Tenon ab interno Xen placements is likely a viable option for POAG patients based on IOP-reduction and number of continued drops post-procedurally. These effects have been demonstrated 41 months and longer after procedure in some cases, showing the long-term efficacy of repeating the sub-Tenon ab interno Xen insertion surgery.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.