Refractive Changes after Glaucoma Surgery—A Comparison between Trabeculectomy and XEN Microstent Implantation
Best-corrected visual acuity often decreases temporarily or permanently after trabeculectomy (TE). The purpose of this study was to compare visual acuity and refractive changes after TE or XEN microstent implantation (XEN) in primary open-angle glaucoma (POAG) or pseudoexfoliation glaucoma (PEX) cas...
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MDPI AG
2022-11-01
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| Online Access: | https://www.mdpi.com/2075-1729/12/11/1889 |
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| author | Caroline Bormann Catharina Busch Matus Rehak Manuela Schmidt Christian Scharenberg Focke Ziemssen Jan Darius Unterlauft |
| author_facet | Caroline Bormann Catharina Busch Matus Rehak Manuela Schmidt Christian Scharenberg Focke Ziemssen Jan Darius Unterlauft |
| author_sort | Caroline Bormann |
| collection | DOAJ |
| description | Best-corrected visual acuity often decreases temporarily or permanently after trabeculectomy (TE). The purpose of this study was to compare visual acuity and refractive changes after TE or XEN microstent implantation (XEN) in primary open-angle glaucoma (POAG) or pseudoexfoliation glaucoma (PEX) cases naïve to prior glaucoma surgery over a 24-month follow-up period. We analyzed 149 consecutive glaucoma patients who received either TE or XEN because of medically uncontrollable POAG or PEX. Intraocular pressure (IOP), IOP-lowering medication use, subjective and objective refraction and best-corrected visual acuity were evaluated. In addition, surgically induced astigmatism (SIA) was calculated and compared using the vector analysis method described by Jaffe and Clayman. A total of 93 eyes (85 POAG; 8 PEX) were treated with TE and 56 eyes (50 POAG; 6 PEX) with XEN. After 24 months, the mean IOP and number of IOP-lowering medications used decreased significantly after TE (<i>p</i> < 0.01) and XEN (<i>p</i> < 0.01). In the TE group, mean best-corrected visual acuity (BCVA) changed from 0.16 ± 0.26 to 0.23 ± 0.28 logMAR (<i>p</i> < 0.01) after 24 months, while mean BCVA did not change significantly in the XEN group (preoperative: 0.40 ± 0.50 logMAR, postoperative: 0.36 ± 0.49 logMAR; <i>p</i> = 0.28). SIA was almost the same in both groups at the end of the 24-month follow-up period (0.75 ± 0.60 diopters after TE and 0.81 ± 0.56 diopters after XEN; <i>p</i> = 0.57). In addition, there was no significant correlation between SIA and the observed BCVA changes or SIA and IOP reduction 12 or 24 months after TE or XEN. Our results demonstrate that TE and XEN are effective methods for reducing IOP and IOP-lowering medication use. The SIA was nearly similar in both groups. The SIA does not seem responsible for the decreased visual acuity after TE. |
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| institution | Directory Open Access Journal |
| issn | 2075-1729 |
| language | English |
| last_indexed | 2024-03-09T18:12:52Z |
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| spelling | doaj.art-80c5af1c82db4e18a4757284f1f3aece2023-11-24T08:57:35ZengMDPI AGLife2075-17292022-11-011211188910.3390/life12111889Refractive Changes after Glaucoma Surgery—A Comparison between Trabeculectomy and XEN Microstent ImplantationCaroline Bormann0Catharina Busch1Matus Rehak2Manuela Schmidt3Christian Scharenberg4Focke Ziemssen5Jan Darius Unterlauft6Department of Ophthalmology, University of Leipzig, Liebigstrasse 10-14, 04103 Leipzig, GermanyDepartment of Ophthalmology, University of Leipzig, Liebigstrasse 10-14, 04103 Leipzig, GermanyDepartment of Ophthalmology, University of Giessen, Friedrichstrasse 18, 35392 Giessen, GermanyDepartment of Ophthalmology, University of Leipzig, Liebigstrasse 10-14, 04103 Leipzig, GermanyAugenärzte am Kurpark, Soltauer Straße 6a, 21335 Lüneburg, GermanyDepartment of Ophthalmology, University of Leipzig, Liebigstrasse 10-14, 04103 Leipzig, GermanyDepartment of Ophthalmology, University of Leipzig, Liebigstrasse 10-14, 04103 Leipzig, GermanyBest-corrected visual acuity often decreases temporarily or permanently after trabeculectomy (TE). The purpose of this study was to compare visual acuity and refractive changes after TE or XEN microstent implantation (XEN) in primary open-angle glaucoma (POAG) or pseudoexfoliation glaucoma (PEX) cases naïve to prior glaucoma surgery over a 24-month follow-up period. We analyzed 149 consecutive glaucoma patients who received either TE or XEN because of medically uncontrollable POAG or PEX. Intraocular pressure (IOP), IOP-lowering medication use, subjective and objective refraction and best-corrected visual acuity were evaluated. In addition, surgically induced astigmatism (SIA) was calculated and compared using the vector analysis method described by Jaffe and Clayman. A total of 93 eyes (85 POAG; 8 PEX) were treated with TE and 56 eyes (50 POAG; 6 PEX) with XEN. After 24 months, the mean IOP and number of IOP-lowering medications used decreased significantly after TE (<i>p</i> < 0.01) and XEN (<i>p</i> < 0.01). In the TE group, mean best-corrected visual acuity (BCVA) changed from 0.16 ± 0.26 to 0.23 ± 0.28 logMAR (<i>p</i> < 0.01) after 24 months, while mean BCVA did not change significantly in the XEN group (preoperative: 0.40 ± 0.50 logMAR, postoperative: 0.36 ± 0.49 logMAR; <i>p</i> = 0.28). SIA was almost the same in both groups at the end of the 24-month follow-up period (0.75 ± 0.60 diopters after TE and 0.81 ± 0.56 diopters after XEN; <i>p</i> = 0.57). In addition, there was no significant correlation between SIA and the observed BCVA changes or SIA and IOP reduction 12 or 24 months after TE or XEN. Our results demonstrate that TE and XEN are effective methods for reducing IOP and IOP-lowering medication use. The SIA was nearly similar in both groups. The SIA does not seem responsible for the decreased visual acuity after TE.https://www.mdpi.com/2075-1729/12/11/1889trabeculectomyXENrefractionvisual acuitysurgically induced astigmatism |
| spellingShingle | Caroline Bormann Catharina Busch Matus Rehak Manuela Schmidt Christian Scharenberg Focke Ziemssen Jan Darius Unterlauft Refractive Changes after Glaucoma Surgery—A Comparison between Trabeculectomy and XEN Microstent Implantation Life trabeculectomy XEN refraction visual acuity surgically induced astigmatism |
| title | Refractive Changes after Glaucoma Surgery—A Comparison between Trabeculectomy and XEN Microstent Implantation |
| title_full | Refractive Changes after Glaucoma Surgery—A Comparison between Trabeculectomy and XEN Microstent Implantation |
| title_fullStr | Refractive Changes after Glaucoma Surgery—A Comparison between Trabeculectomy and XEN Microstent Implantation |
| title_full_unstemmed | Refractive Changes after Glaucoma Surgery—A Comparison between Trabeculectomy and XEN Microstent Implantation |
| title_short | Refractive Changes after Glaucoma Surgery—A Comparison between Trabeculectomy and XEN Microstent Implantation |
| title_sort | refractive changes after glaucoma surgery a comparison between trabeculectomy and xen microstent implantation |
| topic | trabeculectomy XEN refraction visual acuity surgically induced astigmatism |
| url | https://www.mdpi.com/2075-1729/12/11/1889 |
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