The Effectiveness Of Xen-45 Gel Stent In Neovascular Glaucoma Patients

To evaluate the effectiveness of XEN-45 gel glaucoma stent in neovascular glaucoma patients to protect the present visual acuity.

Bursa Yüksek İhtisas Training and Research Hospital, Ophthalmology Department

This is a randomized prospective study. Nine patients were recruited to this study. The neovascular glaucoma patients with medically uncontrolled intraocular pressure (IOP) and without any glaucoma surgery history were selected. The treatment of retinal ischemia causing rubeosis iridis was initiated or continued simultaneously with XEN stent. All patients received 1.25mg/0.05cc Bevacizumab intravitreally before 1 week from the stent implantation. The stent was implanted to the superonasal quadrant with subconjunctival Mitomycin C (0.2 mg/mL) by one surgeon. The patients were followed, postoperatively 1.Day,1.Week,1.Month and 6.Month.

Mean preoperative IOP is 37±7.61 mmHg (Range 25-50) with full topically and oral acetazolamide 250 mg tid.The preoperative visual acuity was ranged from 2.7 to 0.7 LogMAR. Postoperative 1.Day all patients’IOP was decreased and ranged from 6-25 mmHg During follow-up period, three patients’ stents were revised, because it did not lie properly in the subconjunctival area and the IOP was high. One of them’s stent was failed and the IOP could not be controlled and we applied cyclodiode laser.During 6 month,the patients were received approximately 1.25±1.28 intravitreal injection and appropriate panretinal photocoagulation.At the end of the 6 month,the remaining 8 patients IOP was ranged from 7 to 20 mmHg.

The effectiveness of XEN-45 gel stent on miscellaneous glaucoma types was reported in previous studies. As long as the treatment of retinal ischemia is performed simultaneously, XEN-45 gel stent application can provide effective IOP reduction. Thus, optic nerve and the result of this, present vision of patients can be protected.