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Combined surgery: XEN gel stent implantation with phacoemulsification of cataract in glaucoma patients �â�€�“ our experience

Poster Details

First Author: D.Dementiev RUSSIA

Co Author(s):    I. Ivanchikova   A. Shipunova   M. Sysoeva              

Abstract Details

Purpose:

The Xen Gel Stent is a new Ab-interno minimally invasive glaucoma drainage device (by AqueSys, Inc. now Allergan, USA). Xen is made of soft collagen and is introduced by a corneal incision through the anterior chamber angle (ACA) and is positioned under the conjunctiva space. The flexibility and softness of the Xen Gel Stent allows it to imitate the ocular tissue and can minimize many of the issues associated with synthetic materials. The aim of the study was to evaluate the efficacy and safety of the combined surgery involving Xen Gel Stent implantation with Phacoemulsification cataract in Glaucoma patients

Setting:

Ptivate-practice: International center for Ophthalmology, Moscow, Russia

Methods:

Two groups of patients underwent Xen Gel Stent implantation with adjunctive mitomycin C with Phacoemulsification of cataract (Group 1: 7 eyes of 7 patients) and without Phacoemulsification (Group 2: 3 eyes of 3 patients). The complete ophthalmological examination was performed, including Slit-lamp examination, Best corrected visual acuity (BCVA), Intraocular pressure (IOP), Endothelial cell density, Mean deviation(MD) at Humphrey perimetry, Filtering bleb morphology at biomicroscopy, Visante AS-OCT imaging and OCT of retina. The core study parameters which were analyzed included Filtering bleb structure (diffuse or cystic), IOP, Anterior chamber angle (ACA) status and Stability of a position of Xen Gel Stent.

Results:

Group 1 was successful in 7 eyes. Filtering bleb morphology was diffuse and flat. Mean IOP has ranged from 21,79�Â�±2,78 to 15,18�Â�±2,18mmHg. BCVA was improved based on target of IOL. ACD was increased and ACA was expanded. Group 2 was successful in 2 eyes and unsuccessful in 1 eye. Filtering bleb morphology was diffuse and flat in 2 eyes and had a presence of thin-walled cystic bleb with fibrosis in 1 eye. Mean IOP has ranged from 25,79�Â�±1,78 to 16,1�Â�±1,18mmHg in eyes which were deemed successful. Mean IOP in unsuccessful result has ranged from 33 mmHg to 28 mmHg.

Conclusions:

The study has demonstrated the importance of performing Xen Gel Stent implantation in combination with Phacoemulsification of cataract in glaucoma patients. The IOP reduction demonstrated by the combined surgery was superior to an isolated Xen Gel Stent implantation procedure. Long term study efficacy has shown significant IOP improvement in both patient groups. Xen Gel Stent implantation with Phacoemulsification cataract in Glaucoma patients is a minimally invasive, safe, and effective procedure. More studies with a higher number of patients and follow up observations are necessary in order to conclude on an overall statistically significant success rates.

Financial Disclosure:

NONE

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