Efficacy of the XEN-Implant in Glaucoma and a Meta-Analysis of the Literature
Background: To assess the efficacy of XEN-implant surgery in patients with glaucoma, and to perform a meta-analysis of previously published results and compare these to our data. Methods: Prospective case-control study, in which all eyes that underwent XEN-implant surgery were included from 2015 onw...
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| Format: | Article |
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MDPI AG
2021-03-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/10/5/1118 |
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| author | Huub J. Poelman Jan Pals Parinaz Rostamzad Wichor M. Bramer Roger C. W. Wolfs Wishal D. Ramdas |
| author_facet | Huub J. Poelman Jan Pals Parinaz Rostamzad Wichor M. Bramer Roger C. W. Wolfs Wishal D. Ramdas |
| author_sort | Huub J. Poelman |
| collection | DOAJ |
| description | Background: To assess the efficacy of XEN-implant surgery in patients with glaucoma, and to perform a meta-analysis of previously published results and compare these to our data. Methods: Prospective case-control study, in which all eyes that underwent XEN-implant surgery were included from 2015 onwards. Sub-analyses were performed for eyes that underwent XEN-implant as standalone procedure and as cataract-combined procedure. To compare our results, a systematic review was performed using the Embase, PubMed, Web of Science, and Cochrane database. Meta-analyses were performed by combining data (intraocular pressure (IOP), IOP-lowering medication, and complications) from the retrieved studies. Results: A total of 221 eyes underwent XEN-implant surgery (124 standalone and 97 cataract-combined). The mean ± standard deviation IOP declined from 18.8 ± 6.5 to 13.5 ± 4.3 mmHg at the last follow-up (<i>p</i> < 0.001; 28.9%). Postoperative, no significant differences in IOP or IOP-lowering medication were found between patients with and without combined procedure. Secondary surgeries were performed in 20.8% of eyes, most of them (63.0%) within six months. A meta-analysis of 19 studies retrieved from the systematic review showed a two-years postoperative pooled mean (weighted mean difference) of 14.5 (7.3) mmHg and 1.0 (1.6) for IOP and IOP-lowering medications, respectively (compared to 13.5 (5.3) mmHg and 3.2 (2.4) in the current study). Conclusion: XEN-implant surgery was effective and safe in lowering IOP and the number of IOP-lowering medications. There were no differences between standalone and combined procedures. |
| first_indexed | 2024-03-09T05:04:52Z |
| format | Article |
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| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T05:04:52Z |
| publishDate | 2021-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-3af1dff025e146a4bdff34ce739243ab2023-12-03T12:55:55ZengMDPI AGJournal of Clinical Medicine2077-03832021-03-01105111810.3390/jcm10051118Efficacy of the XEN-Implant in Glaucoma and a Meta-Analysis of the LiteratureHuub J. Poelman0Jan Pals1Parinaz Rostamzad2Wichor M. Bramer3Roger C. W. Wolfs4Wishal D. Ramdas5Department of Ophthalmology, Erasmus MC, University Medical Center, 3000 CA Rotterdam, The NetherlandsDepartment of Ophthalmology, Erasmus MC, University Medical Center, 3000 CA Rotterdam, The NetherlandsDepartment of Ophthalmology, Erasmus MC, University Medical Center, 3000 CA Rotterdam, The NetherlandsMedical Library, Erasmus MC, University Medical Center, 3000 CA Rotterdam, The NetherlandsDepartment of Ophthalmology, Erasmus MC, University Medical Center, 3000 CA Rotterdam, The NetherlandsDepartment of Ophthalmology, Erasmus MC, University Medical Center, 3000 CA Rotterdam, The NetherlandsBackground: To assess the efficacy of XEN-implant surgery in patients with glaucoma, and to perform a meta-analysis of previously published results and compare these to our data. Methods: Prospective case-control study, in which all eyes that underwent XEN-implant surgery were included from 2015 onwards. Sub-analyses were performed for eyes that underwent XEN-implant as standalone procedure and as cataract-combined procedure. To compare our results, a systematic review was performed using the Embase, PubMed, Web of Science, and Cochrane database. Meta-analyses were performed by combining data (intraocular pressure (IOP), IOP-lowering medication, and complications) from the retrieved studies. Results: A total of 221 eyes underwent XEN-implant surgery (124 standalone and 97 cataract-combined). The mean ± standard deviation IOP declined from 18.8 ± 6.5 to 13.5 ± 4.3 mmHg at the last follow-up (<i>p</i> < 0.001; 28.9%). Postoperative, no significant differences in IOP or IOP-lowering medication were found between patients with and without combined procedure. Secondary surgeries were performed in 20.8% of eyes, most of them (63.0%) within six months. A meta-analysis of 19 studies retrieved from the systematic review showed a two-years postoperative pooled mean (weighted mean difference) of 14.5 (7.3) mmHg and 1.0 (1.6) for IOP and IOP-lowering medications, respectively (compared to 13.5 (5.3) mmHg and 3.2 (2.4) in the current study). Conclusion: XEN-implant surgery was effective and safe in lowering IOP and the number of IOP-lowering medications. There were no differences between standalone and combined procedures.https://www.mdpi.com/2077-0383/10/5/1118glaucomaintraocular pressureIOP-lowering medicationXEN-implantXEN45gelatin stent |
| spellingShingle | Huub J. Poelman Jan Pals Parinaz Rostamzad Wichor M. Bramer Roger C. W. Wolfs Wishal D. Ramdas Efficacy of the XEN-Implant in Glaucoma and a Meta-Analysis of the Literature Journal of Clinical Medicine glaucoma intraocular pressure IOP-lowering medication XEN-implant XEN45 gelatin stent |
| title | Efficacy of the XEN-Implant in Glaucoma and a Meta-Analysis of the Literature |
| title_full | Efficacy of the XEN-Implant in Glaucoma and a Meta-Analysis of the Literature |
| title_fullStr | Efficacy of the XEN-Implant in Glaucoma and a Meta-Analysis of the Literature |
| title_full_unstemmed | Efficacy of the XEN-Implant in Glaucoma and a Meta-Analysis of the Literature |
| title_short | Efficacy of the XEN-Implant in Glaucoma and a Meta-Analysis of the Literature |
| title_sort | efficacy of the xen implant in glaucoma and a meta analysis of the literature |
| topic | glaucoma intraocular pressure IOP-lowering medication XEN-implant XEN45 gelatin stent |
| url | https://www.mdpi.com/2077-0383/10/5/1118 |
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