XEN^®-45 implantation for refractory uveitic glaucoma

Area of Science:

• Ophthalmology
• Glaucoma Surgery
• Uveitis Management

Background:

• Uveitic glaucoma presents a significant challenge due to uncontrolled intraocular pressure (IOP).
• Medical management is often insufficient for controlling IOP in these complex cases.
• Minimally invasive glaucoma surgery (MIGS) offers a potential alternative for such patients.

Purpose of the Study:

• To evaluate the efficacy of the XEN®-45 gel stent implanted ab interno for medically uncontrolled uveitic glaucoma.
• To assess the reduction in intraocular pressure (IOP) and medication burden.
• To determine the success rates and complication profile of XEN® gel stent implantation in this specific patient population.

Main Methods:

• Retrospective analysis of 25 eyes with medically uncontrolled uveitic glaucoma treated with XEN® gel stent.
• Data collected included intraocular pressure (IOP), medication use, and need for revision surgery.
• Primary outcome was IOP reduction compared to baseline; success defined as IOP ≤18 mmHg with or without medication.

Main Results:

• Mean preoperative IOP was 35.3 mmHg, reduced to 12.0 mmHg at final follow-up (mean 17.7 months), a 62.5% decrease.
• 72% of eyes achieved complete success (IOP ≤18 mmHg without medication).
• 24% of eyes required bleb revision; 12% experienced IOP spikes with uveitis flare-ups.

Conclusions:

• XEN® gel stent implantation is an effective option for reducing IOP in medically uncontrolled uveitic glaucoma.
• A significant proportion of patients achieved complete success, with reduced medication dependency.
• While effective, careful monitoring for complications like bleb revision and IOP spikes is necessary.