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Three-year efficacy and safety outcomes of standalone Ab interno gelatin microstent (Xen45) with MMC vs. trabeculectomy with MMC

Thème:
Glaucome
Quoi:
Paper Presentation | Présentation d'article
Quand:
3:30 PM, dimanche 27 juin 2021 (5 minutes)
Comment:
Discussion:
0

Authors:

John Liu, Matthew Schlenker, Iqbal Ike Ahmed.
University of Toronto.

Author Disclosure Block:

J. Liu: None. M. Schlenker: Funded grants or clinical trials; Name of for-profit or not-for-profit organization(s); Alcon, Bausch Health, J&J, Thea-Labtician. Funded grants or clinical trials; Description of relationship(s); honorarium, unrestricted grant. All other investments or relationships that could be seen by a reasonable, well-informed participant as having the potential to influence the content of the educational activity; Name of for-profit or not-for-profit organization(s); Abbvie, Santen, Zeiss. All other investments or relationships that could be seen by a reasonable, well-informed participant as having the potential to influence the content of the educational activity; Description of relationship(s); consulting, honorarium. I.I. Ahmed: Any direct financial payments including receipt of honoraria; Name of for-profit or not-for-profit organization(s); Alcon, Allergan, Carl Zeiss Meditec, Johnson & Johnson Vision, MST Surgical, Mundipharma. Any direct financial payments including receipt of honoraria; Description of relationship(s); Speakers Honoraria. Funded grants or clinical trials; Name of for-profit or not-for-profit organization(s); Alcon, Allergan, Camras Vision, Glaukos, Ivantis, Johnson & Johnson Vision, New World Medical, Santen. Funded grants or clinical trials; Description of relationship(s); Research Grants/Support. All other investments or relationships that could be seen by a reasonable, well-informed participant as having the potential to influence the content of the educational activity; Name of for-profit or not-for-profit organization(s); Aequus, Aerie Pharmaceuticals, Akorn. Allergan, ArcScan, Bausch Health, Beaver Visitec, Beyeonics, Camras Vision, Carl Zeiss Meditec, CorNeat Vision, Ellex, ELT Sight, ElutiMed, Equinox, Genentech, Gl. All other investments or relationships that could be seen by a reasonable, well-informed participant as having the potential to influence the content of the educational activity; Description of relationship(s); Consulting.

Abstract Body:

Purpose: To compare 3-year post-operative efficacy and safety of standalone ab interno gelatin microstent (Xen45) versus trabeculectomy. There is currently no published long-term data on the Xen45, nor long-term comparative data with trabeculectomy.
Study Design: This is a single-centre retrospective cohort study.
Methods: Patients included were consecutive patients from June 2012-July 2017 who received standalone Xen45 or standalone trabeculectomy. The primary outcome was time to failure, defined as intraocular pressure (IOP) outside of 6mmHg - 17mmHg on no medications on two consecutive visits despite in-clinic maneuvers (including needling). Secondary outcomes included IOP cutoffs of 14mmHg and 21mmHg with and without medications, as well as interventions, complications, and reoperations.
Results: A total of 173 eyes in 160 patients received Xen45 and 82 eyes in 71 patients received trabeculectomy. Hazard Ratio for Xen45 relative to trabeculectomy was 1.28 (95% CI 0.95-1.72). Proportional complete success at 1, 2, and 3 years for Xen45 were 0.61 (0.04), 0.50 (0.04), and 0.42 (0.04) and for trabeculectomy were 0.73 (0.05), 0.58 (0.06), and 0.52 (0.06). Both Xen45 and trabeculectomy had a similar number of interventions (66% vs. 68%, p=0.77), most of which were needling, and a similar number of complications (75% vs. 71%, p=0.52), most of which were transient. There was a higher rate of reoperation with Xen45 (32.4% vs. 19.5%), which was significant (p=0.03).
Conclusions: Standalone Xen demonstrated a good success rate and safety profile at 3 years post-operative follow-up, comparable to standalone trabeculectomy - although with a higher reoperation rate.


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