XEN45 Implant in Medically Controlled vs. Uncontrolled Eyes-Differential IOP Changes in Real-Life Conditions

Area of Science:

• Ophthalmology
• Glaucoma Surgery
• Medical Devices

Background:

• Assessing intraocular pressure (IOP) changes and complications following XEN45 implants.
• Comparing outcomes in medically controlled eyes (MCE) versus medically uncontrolled eyes (MUE).

Purpose of the Study:

• To evaluate the efficacy and safety of XEN45 implants in mild-to-moderate primary open-angle glaucoma (POAG) patients.
• To analyze IOP fluctuations and complication rates in MCE and MUE groups post-implantation.

Main Methods:

• Retrospective study of 62 primary open-angle glaucoma (POAG) patients (32 MCE, 30 MUE) at a tertiary referral hospital.
• Kaplan-Meier analysis used to define success criteria: IOP < 21 mmHg without medications or reduced medication use.
• Follow-up duration averaged 26-28 months, assessing IOP and complications.

Main Results:

• No significant preoperative differences between MCE and MUE groups.
• XEN45 implants significantly reduced IOP at 24 hours in both groups.
• MCE group showed a trend of increasing IOP post-reduction, returning to baseline by 1 month; MUE group maintained reduced IOP.
• No major complications or significant differences in survival analysis between groups.

Conclusions:

• XEN45 implants offer stable medium-term IOP control in both MCE and MUE groups without significant complications.
• The observed IOP increase in MCE post-surgery warrants further investigation into homeostatic mechanisms.
• Further research is needed to clarify the homeostatic mechanisms driving IOP rise and their link to failure cases.