Choroidal Detachment after XEN Gel Stent Implantation
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Carlo Alberto Cutolo1,2, Letizia Negri1,2, Sara Olivari1,2
1Clinica Oculistica, Department of Neuroscience Rehabilitation Ophthalmology Genetics Maternal and Child Health (DiNOGMI), University of Genoa, Genoa, Italy.
Insights
Choroidal detachment (CD) occurred in 19.8% of patients after XEN gel stent surgery. Older age, lower postoperative IOP, and more preoperative medications were linked to CD development.
Area of Science:
- Ophthalmology
- Surgical Complications
- Glaucoma Surgery
Background:
- XEN gel stent implantation is a surgical procedure for glaucoma.
- Choroidal detachment (CD) is a potential complication following intraocular surgeries.
- Estimating the incidence and identifying risk factors for CD after XEN surgery is crucial for patient safety.
Purpose of the Study:
- To determine the incidence of choroidal detachment (CD) after XEN gel stent implantation.
- To identify ocular, demographic, and perioperative factors associated with CD development.
Main Methods:
- Retrospective chart review of 126 patients undergoing XEN implantation.
- Analysis of ocular, demographic, and perioperative data.
- Univariate and multivariate logistic regression to assess factors linked to CD.
Main Results:
- Choroidal detachment (CD) occurred in 19.8% of patients.
- Significant associations with CD included older age (OR=1.10), lower early postoperative intraocular pressure (IOP) (OR=0.70), and increased number of preoperative IOP-lowering drugs (OR=5.70).
- Wide-field imaging and ultrasonography aided in diagnosis and follow-up, with complete resolution in all cases.
Conclusions:
- Choroidal detachment (CD) is a relatively common complication after XEN gel stent surgery.
- Risk factors for CD include advanced age, reduced postoperative IOP, and a higher number of preoperative medications.
- Careful investigation and monitoring are recommended for patients undergoing XEN implantation.
Background:
The purpose of this study is to estimate the incidence of choroidal detachment (CD) after XEN gel stent implant surgery and to evaluate the associated factors.
Methods:
We reviewed the clinical charts of 126 patients who underwent XEN implantation between March 1, 2016, and December 31, 2018 at the University Eye Clinic of Genoa. Ocular, demographics, and perioperative factor were registered and analysed. Univariate and multivariate logistic analysis were performed to investigate factors associated with CD occurrence.
Results:
Of the 126 patients, 25 (19.8%) developed a choroidal detachment after XEN gel stent implant surgery. The mean period between surgery and CD detection was 5.84 ± 1.77 days. The mean intraocular pressure (IOP) at the time of CD diagnosis was 6.4 ± 3.1 mmHg. Age (OR = 1.10, p < 0.019), early postoperative IOP (OR = 0.70, p < 0.001), and number of preoperative IOP-lowering drugs (OR = 5.70, p < 0.001) were significantly associated with CD presence. Complete resolution was observed in all the cases. Wide-field imaging and ultrasonography were useful tools to diagnose and follow up CD until resolution.
Conclusions:
When carefully investigated, CD is a relatively common complication after XEN gel stent implant procedure. Older age, lower postoperative IOP, and higher number of preoperative IOP-lowering drugs were significantly associated with the development of CD.
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