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Comparison of 1 year outcomes of XEN implantation alone vs combined phacoemulsification-XEN surgery

Poster Details

First Author: N.Moura-Coelho PORTUGAL

Co Author(s):    D. Hipolito Fernandes   S. Crisostomo   A. Basilio   M. Dutra-Medeiros   M. Sa Cardoso   T. Gomes     

Abstract Details


To compare the 1-year efficacy and safety of the XEN45 Gel Stent (Allergan, Irvine, CA) implantation alone versus combined Xen implantation and phacoemulsification (Phaco-Xen) in patients with medically refractory open-angle glaucoma (mrOAG).


Department of Ophthalmology, Central Lisbon Hospital Centre, Lisbon (Portugal).


Retrospective comparative interventional case series of 19 eyes (18 patients) with mrOAG who underwent XEN surgery (isolated or Phaco-Xen) at our institution, a tertiary center for Ophthalmology in Portugal reporting the initial experience with XEN nationwide. Outcomes measured at 12-month follow-up included intra-ocular pressure (IOP) reduction and reduction rate (IOP-RR), number of IOP-lowering drugs, and complications. Success was defined as IOP-RR ≥ 20% and IOP < 18 mmHg and > 5 mmHg, with (qualified) or without (complete) need for IOP-lowering drugs, without further procedures for glaucoma including needling.


At 12-month post-XEN implantation, there was significant reduction in median IOP (5,0 mmHg, p-value = 0,050) in the isolated XEN group, but not in the Phaco-Xen group (median IOP reduction 8,0 mmHg, p-value = 0,123). Nevertheless, no statistically significant differences between both patient groups were observed in IOP-RR (p-value = 0,680) drug reduction (p-value = 0,056), number of successful cases (p-value = 0,605), and number of complications (p-value= 0,457).


In our study, XEN implantation showed good efficacy in medically refractory OAG at 1 year. Combining cataract surgery showed neither added IOP-lowering benefit nor association with inferior success or increased number of complications. Larger, prospective studies are needed to ascertain whether cataract surgery may have an added IOP-lowering benefit in XEN surgery.

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