Efficacy and safety of XEN45 implant in Thai eyes with primary open angle glaucoma; one year result
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Abstract
Purpose: To report the efficacy and safety of the XEN45 implant in Thai patients with primary open angle glaucoma (POAG).
Method: Retrospective study of POAG patients who underwent XEN45 implant glaucoma surgery in June 2019 or later and completed 12 months of follow up. Primary outcome measures were intraocular pressure (IOP) reduction and number of glaucoma medications at 12 months postoperatively. Secondary outcome measures were surgical complications and success rate of surgery at 1 year. Complete success was defined as a postoperative IOP drop of ≥ 20 % from preoperative baseline at 12 months without any glaucoma medications. Qualified success was define as a postoperative IOP reduction of ≥ 20 % at 12 months with glaucoma medications. Failure was define as < 20 % reduction of IOP from baseline at 1 year, visual loss of light perception, or need for additional glaucoma surgery. Needling with 5-fluorouracil (5-FU) injection of the XEN conjunctival bleb was not considered to constitute a surgical failure.
Results: Thirteen eyes of 10 patients were included in the study. The mean IOP dropped from 23.2±4.5 mmHg preoperatively to 13.7 ± 2.9 mmHg at 12 months, a 40.9 % IOP reduction (p< 0.0001). Mean number of glaucoma medications reduced from 2.5±0.9 preoperatively to 1.1±1.1 at 12 months (p< 0.0001). Success rate was 76.9 % at 12- month follow up, 46.1 % (6 eyes) achieved complete success and 30.8 % (4 eyes) achieved qualified success. Seven eyes (53.8%) required bleb needling with 5-FU injection. Seven eyes (53.8 %) required glaucoma medications. Three eyes (23.1%) exhibited numeric hypotony which resolved without intervention by 1 week. There was no serious complications and required glaucoma surgery at 12-month follow up.
Conclusion: The XEN45 implant proved to be an effective treatment with a good safety profile at 1-year follow up period in Thai patients with POAG. Patients considering this procedure should be warranted that by 1 year postoperatively there is a significant chance of requiring postoperative bleb needling and glaucoma medications.
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References
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