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Long-Term Morphological Changes of Crosslinked Gelatin Stent
Yuen Keat Gan1, Hong Kee Ng1, William H Morgan1,2
1Lions Eye Institute, Nedlands, Western Australia, Australia.
Clinical & Experimental Ophthalmology
|April 28, 2025
Summary
Long-term follow-up of crosslinked gelatin stents shows significant morphological changes after 11 years. These changes, including external nibbling, can lead to stent degradation and luminal obstruction, impacting intraocular pressure control.
Area of Science:
- Ophthalmology
- Biomaterials Science
Background:
- Investigating the long-term (10-year) morphological outcomes of crosslinked gelatin stents.
- Assessing the durability and degradation patterns of these implants in vivo.
Purpose of the Study:
- To evaluate the long-term morphological changes in crosslinked gelatin stents.
- To determine the relationship between stent morphology and clinical outcomes over a decade.
Main Methods:
- Recalled participants (9-12 years post-implantation) from XEN 140 stent trials.
- Utilized anterior segment optical coherence tomography (AS-OCT) and clinical assessments.
- Measured stent dimensions, external surface pitting (nibbling), wall breaches, and luminal obstruction.
Main Results:
- 11 eyes from 9 patients followed for an average of 11.2 years.
- Mean intraocular pressure (IOP) decreased from 22.5 mmHg preoperatively to 14.7 mmHg postoperatively.
- Stent wall nibbling observed in all analyzed cases (8/11), most frequent in the proximal conjunctival area.
- Hyperreflective lumens and one complete stent wall discontinuity were noted.
Conclusions:
- Crosslinked gelatin stents undergo significant morphometric changes over 11 years.
- Degradation appears to initiate externally, potentially leading to luminal obstruction and stent failure.
- These findings highlight the importance of long-term monitoring for stent integrity and efficacy.
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