Xen63 As A Rescue Procedure In Cases Of Refractory Glaucoma: One-Year Results

To assess the efficacy and safety of the XEN®63 Gel Implant as a rescue procedure in cases of refractory glaucoma.

This was a single-center consecutive case series.

Eyes with elevated intraocular pressure (IOP) on maximally tolerated medical therapy despite at least one previous glaucoma surgery underwent implantation of the XEN®63 Gel Implant. One-year outcomes included surgical success (absence of subsequent glaucoma surgeries), mean IOP and medications, and proportions of eyes with IOP ≤18, ≤15, and ≤12 mmHg. Safety measures included best-corrected visual acuity (BCVA), cup-to-disc ratio (CDR), visual field-mean deviation (VF-MD), retinal nerve fiber layer (RNFL) thickness, ganglion cell-inner plexiform layer (GC-IPL) thickness, and adverse events.

A total of 62 eyes of various glaucoma subtypes and severities having previously undergone a mean of 2.06±1.41 glaucoma surgeries were included. Mean IOP decreased from 26.51±7.98 mmHg preoperatively to 14.38±8.75 mmHg (45.8%, P < 0.0001) at postoperative year one. Medication use decreased from 4.19±1.43 medications preoperatively to 1.57±1.77 (62.5%, P < 0.0001) at postoperative year one. BCVA, VF-MD, CDR, RNFL thickness, and GC-IPL thickness remained stable throughout follow-up. Adverse events were mild and non-sight threatening, including XEN®63 occlusion in two eyes; cystoid macular edema in 5 eyes; epiretinal membrane in one eye; and transient choroidal detachment in 7 eyes, only one of which required surgical drainage.

In cases of refractory glaucoma and previously failed glaucoma surgeries, the XEN®63 Gel Implant is an effective surgical option, offering a significant reduction in IOP, a good success rate, and a good safety profile with one year of follow-up.