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Minimally invasive glaucoma surgery: practical experience with the XEN gel stent, the iStent and the CyPass

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Session Details

Session Title: Glaucoma

Session Date/Time: Monday 09/10/2017 | 08:00-10:30

Paper Time: 10:12

Venue: Room 4.1

First Author: : K.Klabe GERMANY

Co Author(s): :    A. Fricke   C. Ullmann   G. Auffarth   D. Breyer   R. Fulga   H. Kaymak     

Abstract Details

Purpose:

The development of new surgical systems, such as various micro-bypass stents, has resulted in the increasing importance of minimally invasive glaucoma surgery (MIGS). Here, we report about the first comparative results of using the Xen gel stent, the iStent and the Cypass in our clinic.

Setting:

Internationale Innovative Ophthalmochirurgie Düsseldorf, Germany; International Vision Correction Research Network, Germany

Methods:

113 patients with open-angle glaucoma had an implant of Xen-Gel stent (43% phake), 74 of iStent (100% phake) and 34 of Cypass (43% phake). Before and after the surgery the intraocular pressure (IOP) and the visual acuity was monitored continuously. Filtering blebs were analyzed by swept-source OCT (Cirrus HD-OCT; Zeiss / DRI OCT; Topcon).

Results:

All used MIGS showed a significant decrease of IOP within one week postoperatively. So, we observed a decrese of the IOP to 10.5mmHg (corresponding to a reduction of 51%) by implantation of Xen gel stent. One and seven months postoperative the IOP was quite stable at 17 ± 7 mmHg (26%) and 15 ± 3 mmHg (33%). This pressure-regulating effect was accompanied by a marked reduction in the prescribed pressure-reducing active medications. The majority of patients were postoperatively without any medication. Almost all operations were without complications, we observed same cases of slight hyphema and one case of retinal detachment.

Conclusions:

All three MIGS have shown a very good pressure-lowering and pressure-regulating effect in our clinic. An important consequence of MIGS is the reduction of pressure-lowering medication. A further positive consequence of the stents used here is the minor side effects. Additional long-term results remain to be seen.

Financial Disclosure:

receives consulting fees, retainer, or contract payments from a competing company

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