After trabeculectomy, 3 patients experienced transient bleb leaks. With respect to qualified surgical success, we found similar results for the proportions after 6 months and one year. XEN implant device versus trabeculectomy, either alone or in combination with phacoemulsification, in open-angle glaucoma patients. Authored by internationally recognised experts in ophthalmic surgery, this new edition has been fully revised and updated. Nearly 1000 clinical photographs, illustrations and tables further enhance the extensive text. Any necessary interventions (including laser suture lysis, and digital ocular compression posterior to the scleral flap increasing the scleral outflow) were performed on site during the inpatient stay. Additionally, Dr. Ayyala discusses the benefits of an ab-externo approach for Xen implantation, and the importance of applying mitomycin C during surgery. Satisfaction With XEN Gel Stent Versus Trabeculectomy for the Treatment of Glaucoma (XENPRO) The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. However, the clustered logistic regression mixed model, adjusting for gender, age, preoperative IOD or the number of medication classes used preoperatively, did not alter our finding that there is no evidence of a difference in the proportion of success between both study groups. To compare surgical success, postoperative intraocular pressure and complication rates between trabeculectomy and XEN gelstent surgery in a cohort of glaucoma patients in a typical clinical setting. After disinfection with povidone iodine, 0.02 mg MMC (0.1 ml) was injected under the conjunctiva posterior to the area of the planned gelstent injection site (at least 9 mm from the limbus). Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie . Thread starter smcgee; Start date Sep 16, 2020; Sort by date. The XEN implant is a newly developed device designed to be used as a minimally invasive surgical treatment for glaucoma patients. XEN surgery is generally performed for glaucoma patients who require further lowering of internal eye pressure (intraocular pressure) when glaucoma drops and laser therapy have failed. 6,7 The Xen® Gel Stent is one of these newer minimally invasive surgical techniques. J Glaucoma 2018;27(2):140-147. Clipboard, Search History, and several other advanced features are temporarily unavailable. When inserted into the eye, it decreases the intraocular pressure by creating an extra drainage channel to allow constant release of additional internal eye fluid (aqueous humor) to a space under the conjunctiva (the clear membrane that covers the white of the eye) to create a … There, the IOP-reduction was 10.5 ± 9.2 mmHg in the trabeculectomy group and 7.2 ± 8.2 mmHg in the XEN group. Citation: Wagner FM, Schuster AK-G, Emmerich J, Chronopoulos P, Hoffmann EM (2020) Efficacy and safety of XEN®—Implantation vs. trabeculectomy: Data of a “real-world” setting. https://doi.org/10.1371/journal.pone.0231614.s001. First, it is a single center retrospective study. No, Is the Subject Area "Eyes" applicable to this article? Secondly, the two implants use a different method of … As the first text completely devoted to this topic, Anterior Segment Optical Coherence Tomography comprehensively explains both the scientific principles and the clinical applications of this exciting and advancing technology. The main outcome measure was intraocular pressure (IOP). Xen drains fluid to the same space as traditional glaucoma surgery, but is less invasive. Messages 1 Location Cape Coral, FL Best answers 0. The primary outcome was the proportion of surgical success at 1 year after XEN-implantation compared to trabeculectomy; we distinguished complete success and qualified success. Francis W. Price, MD. who was the first to complete DSEK in the United States, along with Marianne Price, PhD, have designed this text to offer a special emphasis on how to perform surgeries along with preventing and managing complications. Complications included anterior chamber flattening (one eye), XEN implant extrusion (four eyes), one of whom had an endophthalmitis that required vitrectomy, and one eye underwent a trabeculectomy due to inadequate intraocular pressure control. Even if the number of patients is reasonable high for a single center study, the sample size is still small considering the small differences between the two investigated methods. Bookshelf A review of the literature. Therefore, long-term investigations are desired. XEN implant, either alone or in combination with phacoemulsification, significantly reduces both IOP and the number of antiglaucoma medications to a similar rate than trabeculectomy, but with a better safety profile. Yes -, Ophthalmology. 7. https://doi.org/10.1371/journal.pone.0231614.t001. Patients who did not fail these criteria and did not necessitate glaucoma medication post-operatively were considered as complete success. Marcos Parra et al., who compared XEN stent with trabeculectomy, found that the XEN implant significantly reduces IOP to a similar rate than trabeculectomy. A main and a side-port paracentesis were made, and the anterior chamber was filled with viscoelastic (Healon® or Healon GV®). Yes The complete success proportion was 65.5% (95%-CI: 55.6–75.9%) in the trabeculectomy group, and 58.5% (95%-CI: 47.6–69.4%) in the XEN group and not statistically different in our analysis model (crude OR = 0.61; 95%-CI: 0.31–1.22; adjusted OR = 0.66; 95%-CI: 0.32–1.37). In conclusion, both XEN gelstent implantation and trabeculectomy in patients with refractory open-angle glaucoma show comparable surgical success proportions and similar proportions of complications and are therefore both recommendable for clinical routine. 2007 Dec;35(9):812-7 Gedde et al. Final codes pending. 2021 Jul 13;13:581-592. doi: 10.2147/CLEP.S310542. Recently approved by the FDA, the Xen is a hydrophilic cylindrical implant of porcine gelatin cross-linked with glutaraldehyde (Figure). This book describes and illustrates over 40 innovative procedures using this technology. Each section focuses on an anatomic area and details disorders that are treated with the Fugo blade. Trabeculectomy (guarded filtration surgery) is the most established surgical procedure for glaucoma, which involves dissecting the conjunctiva, creating a scleral flap and scleral ... and XEN gelatin stent. Yes 171 eyes of 144 patients were included, including 82 eyes of 58 patients in the XEN group and 89 eyes of 86 patients in the trabeculectomy group. Funding: The authors received no specific funding for this work. The most common reason for surgical failure was the necessity for further surgery to lower IOP in both the trabeculectomy and XEN group. Glaucoma is a major cause for visual impairment and blindness in industrialized countries, with an increasing number of people affected [1]. The primary outcome defined as the proportion of surgical success after 1 year (mean 11.1 months ± 2.2) was similar for both groups. The XEN ® 45 Gel Stent is a hydrophilic, non-inflammatory, subconjunctival gelatin stent. The mean postoperative IOP reduction after trabeculectomy reported in … XEN gel implant. Patients will be randomized 2:1, resulting in approximately 190 eyes being implanted with XEN and approximately 95 eyes will be receiving trabeculectomy. How does the Xen work? Conclusion At 24 months, XEN showed a rate of success comparable to that of trabeculectomy. Both are highly effective, yet invasive and complication-prone solutions. … The applied criteria for surgical failure by Schlenker et al. Found inside – Page 1180Ab interno trabeculectomy versus trabeculectomy for open-angle glaucoma. ... The XEN Gel Stent. ... FDA 510(k) Summary: XEN Glaucoma Treatment System. Found inside – Page 223Another retrospective study comparing standalone Xen implantation versus trabeculectomy has shown comparable risk of failure and safety profile at 1 year ... This study aimed to analyze the surgical and refractive outcomes of XEN glaucoma implant (Allergan, an Abbvie company, Irvine, CA, USA), a minimally invasive surgical device for the treatment of operated uncontrolled glaucoma. Yet, in many studies MMC-related complications such as prolonged wound leaks, hypotony with choroidal effusions and maculopathy, thin avascular blebs, and/or bleb leaks with late infection are frequently reported [1–9].A biodegradable collagen … Follow-up data was obtained through chart review and correspondence with ophthalmologists engaged in patient follow-up. The XEN gel implant (pronounced ‘zen’) is a thin tube that is inserted into the eye to create a new drainage path for the fluid. Methods: Please enable it to take advantage of the complete set of features! Wang Y-W, Wang P-B, Zeng C, Xia X-B. Atlas of Glaucoma, Third Edition provides an in-depth review and analysis of the management of glaucoma an WARNINGS. (e in b.c))if(0>=c.offsetWidth&&0>=c.offsetHeight)a=!1;else{d=c.getBoundingClientRect();var f=document.body;a=d.top+("pageYOffset"in window?window.pageYOffset:(document.documentElement||f.parentNode||f).scrollTop);d=d.left+("pageXOffset"in window?window.pageXOffset:(document.documentElement||f.parentNode||f).scrollLeft);f=a.toString()+","+d;b.b.hasOwnProperty(f)?a=!1:(b.b[f]=!0,a=a<=b.g.height&&d<=b.g.width)}a&&(b.a.push(e),b.c[e]=!0)}y.prototype.checkImageForCriticality=function(b){b.getBoundingClientRect&&z(this,b)};u("pagespeed.CriticalImages.checkImageForCriticality",function(b){x.checkImageForCriticality(b)});u("pagespeed.CriticalImages.checkCriticalImages",function(){A(x)});function A(b){b.b={};for(var c=["IMG","INPUT"],a=[],d=0;d