Clinical Outcomes of XEN45<sup>®</sup>-Stent Implantation after Failed Trabeculectomy: A Retrospective Single-Center Study

Background: The implantation of a collagen gel micro-stent (XEN45<sup>®</sup>) as a minimally invasive form of glaucoma surgery (MIGS) after a failed trabeculectomy (TE) may be an effective option with few risks. This study investigated the clinical outcome of XEN45<sup>®</sup&g...

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Main Authors: Constance Weber, Sarah Hundertmark, Michael Petrak, Elisabeth Ludwig, Christian Karl Brinkmann, Frank G. Holz, Karl Mercieca
Format: Article
Language:English
Published: MDPI AG 2023-02-01
Series:Journal of Clinical Medicine
Subjects:
Online Access:https://www.mdpi.com/2077-0383/12/4/1296
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author Constance Weber
Sarah Hundertmark
Michael Petrak
Elisabeth Ludwig
Christian Karl Brinkmann
Frank G. Holz
Karl Mercieca
author_facet Constance Weber
Sarah Hundertmark
Michael Petrak
Elisabeth Ludwig
Christian Karl Brinkmann
Frank G. Holz
Karl Mercieca
author_sort Constance Weber
collection DOAJ
description Background: The implantation of a collagen gel micro-stent (XEN45<sup>®</sup>) as a minimally invasive form of glaucoma surgery (MIGS) after a failed trabeculectomy (TE) may be an effective option with few risks. This study investigated the clinical outcome of XEN45<sup>®</sup> implantation after a failed TE, with follow-up data of up to 30 months. Materials and Methods: In this paper, we present a retrospective review of patients undergoing XEN45<sup>®</sup> implantation after a failed TE at the University Eye Hospital Bonn, Germany, from 2012 to 2020. Results: In total, 14 eyes from 14 patients were included. The mean follow-up time was 20.4 months. The mean time duration between the failed TE and XEN45<sup>®</sup> implantation was 110 months. The mean intraocular pressure (IOP) decreased from 17.93 mmHg to 12.08 mmHg after one year. This value increased again to 17.63 mmHg at 24 months and 16.00 mmHg at 30 months. The number of glaucoma medications decreased from 3.2 to 0.71, 2.0, and 2.71 at 12, 24, and 30 months, respectively. Conclusions: XEN45<sup>®</sup> stent implantation after a failed TE did not lead to an effective long-term decrease in IOP and glaucoma medications in many patients in our cohort. Nevertheless, there were cases without the development of a failure event and complications, and others in whom further, more invasive surgery was delayed. XEN45<sup>®</sup> implantation in some failed trabeculectomy cases may, therefore, be a good option, especially in older patients with multiple comorbidities.
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spelling doaj.art-c0a56fc479b04bc2965eabff916e0ecc2023-11-16T21:17:34ZengMDPI AGJournal of Clinical Medicine2077-03832023-02-01124129610.3390/jcm12041296Clinical Outcomes of XEN45<sup>®</sup>-Stent Implantation after Failed Trabeculectomy: A Retrospective Single-Center StudyConstance Weber0Sarah Hundertmark1Michael Petrak2Elisabeth Ludwig3Christian Karl Brinkmann4Frank G. Holz5Karl Mercieca6Department of Ophthalmology, University of Bonn, 53127 Bonn, GermanyDepartment of Ophthalmology, University of Bonn, 53127 Bonn, GermanyDepartment of Ophthalmology, University of Bonn, 53127 Bonn, GermanyDepartment of Ophthalmology, University of Bonn, 53127 Bonn, GermanyDepartment of Ophthalmology, University of Bonn, 53127 Bonn, GermanyDepartment of Ophthalmology, University of Bonn, 53127 Bonn, GermanyDepartment of Ophthalmology, University of Bonn, 53127 Bonn, GermanyBackground: The implantation of a collagen gel micro-stent (XEN45<sup>®</sup>) as a minimally invasive form of glaucoma surgery (MIGS) after a failed trabeculectomy (TE) may be an effective option with few risks. This study investigated the clinical outcome of XEN45<sup>®</sup> implantation after a failed TE, with follow-up data of up to 30 months. Materials and Methods: In this paper, we present a retrospective review of patients undergoing XEN45<sup>®</sup> implantation after a failed TE at the University Eye Hospital Bonn, Germany, from 2012 to 2020. Results: In total, 14 eyes from 14 patients were included. The mean follow-up time was 20.4 months. The mean time duration between the failed TE and XEN45<sup>®</sup> implantation was 110 months. The mean intraocular pressure (IOP) decreased from 17.93 mmHg to 12.08 mmHg after one year. This value increased again to 17.63 mmHg at 24 months and 16.00 mmHg at 30 months. The number of glaucoma medications decreased from 3.2 to 0.71, 2.0, and 2.71 at 12, 24, and 30 months, respectively. Conclusions: XEN45<sup>®</sup> stent implantation after a failed TE did not lead to an effective long-term decrease in IOP and glaucoma medications in many patients in our cohort. Nevertheless, there were cases without the development of a failure event and complications, and others in whom further, more invasive surgery was delayed. XEN45<sup>®</sup> implantation in some failed trabeculectomy cases may, therefore, be a good option, especially in older patients with multiple comorbidities.https://www.mdpi.com/2077-0383/12/4/1296glaucoma surgeryMIGStrabeculectomyXENfibrosis
spellingShingle Constance Weber
Sarah Hundertmark
Michael Petrak
Elisabeth Ludwig
Christian Karl Brinkmann
Frank G. Holz
Karl Mercieca
Clinical Outcomes of XEN45<sup>®</sup>-Stent Implantation after Failed Trabeculectomy: A Retrospective Single-Center Study
Journal of Clinical Medicine
glaucoma surgery
MIGS
trabeculectomy
XEN
fibrosis
title Clinical Outcomes of XEN45<sup>®</sup>-Stent Implantation after Failed Trabeculectomy: A Retrospective Single-Center Study
title_full Clinical Outcomes of XEN45<sup>®</sup>-Stent Implantation after Failed Trabeculectomy: A Retrospective Single-Center Study
title_fullStr Clinical Outcomes of XEN45<sup>®</sup>-Stent Implantation after Failed Trabeculectomy: A Retrospective Single-Center Study
title_full_unstemmed Clinical Outcomes of XEN45<sup>®</sup>-Stent Implantation after Failed Trabeculectomy: A Retrospective Single-Center Study
title_short Clinical Outcomes of XEN45<sup>®</sup>-Stent Implantation after Failed Trabeculectomy: A Retrospective Single-Center Study
title_sort clinical outcomes of xen45 sup r sup stent implantation after failed trabeculectomy a retrospective single center study
topic glaucoma surgery
MIGS
trabeculectomy
XEN
fibrosis
url https://www.mdpi.com/2077-0383/12/4/1296
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