Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 May-Aug;16(2):84-90.
doi: 10.5005/jp-journals-10078-1364.

Efficacy of the XEN45 Implant in Advanced to End-stage Glaucoma Patients

Isaac Hindi  1 , Eran Berkowitz  1 , Inbar Waizer  1 , Beatrice Tiosano  1
Affiliations

Efficacy of the XEN45 Implant in Advanced to End-stage Glaucoma Patients

Isaac Hindi et al. J Curr Glaucoma Pract. 2022 May-Aug.

Abstract

Purpose: To report the efficacy of the XEN45 implant in advanced to end-stage glaucoma patients, after a 6 months follow-up.

Methods: Retrospective, noncomparative electronic health record audit of patients who had undergone an XEN45 procedure. The main outcome measures were intraocular pressure (IOP) reduction and the number of antihypertensive medications. Secondary outcome measures were the rates of early postoperative complications. Complete and qualified success; failure and hypotony were defined according to the World Glaucoma Association guidelines (Shaarawy TM et al.). Needling rates and short-term complications were assessed and a subgroup analysis was performed.

Results: A total of 39 eyes with advanced to end stage-glaucoma were included. Twenty eyes (51%) had undergone combined cataract surgery and 19 (49%), the XEN45 procedure alone. Mean IOP decreased from 19.67 ± 7.87 mm Hg to 13.18 ± 6.09 mm Hg; the number of medications decreased from a median use of 4 (IQR 2-5) to 0 (IQR 0-1). Complete success was achieved in 24 (61.5%) of the eyes, qualified success in 10 (25.6%), and failure in five (12.82%). Needling was required in 15 (38.46%) of the eyes at 6 months. Choroidal detachment occurred in eight (20.51%) eyes, numerical hypotony (IOP ≤ 5 mm Hg) at day 1 was noted in seven (17.95%) eyes with a full resolution by 2 weeks.

Conclusion: In this short-term follow-up, we have seen that XEN45 is a viable, effective, and safe procedure utilized in advanced to end-stage glaucoma patients. Treating cases of significant hypotony using AC reformation with sulfur hexafluoride (SF6) is a safe and effective procedure.

How to cite this article: Hindi I, Berkowitz E, Waizer I, et al. Efficacy of the XEN45 Implant in Advanced to End-stage Glaucoma Patients. J Curr Glaucoma Pract 2022;16(2):84-90.

Keywords: Advanced glaucoma; End-stage glaucoma; Hypotony; Needling; XEN45.

PubMed Disclaimer

Conflict of interest statement

Source of support: Nil Conflict of interest: None

Figures

Fig. 1
Fig. 1
A patient with over-filtration, chemosis 360 degrees, and shallow anterior chamber. The pupil is pharmacologically dilated
Figs 2A and B
Figs 2A and B
(A) Demonstrates an intraoperative injection of SF6 into the anterior chamber (B) Postoperative day 2 of the same patient, showing deepening of the anterior chamber, arrow marks XEN45, asterisk the subconjunctival gas
Fig. 3
Fig. 3
IOP at baseline and 6 months postsurgery (Tukey test)
Fig. 4
Fig. 4
IOP measurement during the study (line graph)
Fig. 5
Fig. 5
Medication at baseline and 6 months postsurgery (Tukey test)
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Tham Y-C, Li X, Wong TY, et al. Global prevalence of glaucoma and projections of glaucoma burden through 2040: a systematic review and meta-analysis. Ophthalmology. 2014;121(11):2081–2090. doi: 10.1016/j.ophtha.2014.05.013. - DOI - PubMed
    1. Kidd MN, O'Connor M. Progression of field loss after trabeculectomy: a five-year follow-up. Br J Ophthalmol. 1985;69(11):827–831. doi: 10.1136/bjo.69.11.827. - DOI - PMC - PubMed
    1. Heijl A, Leske MC, Bengtsson B, et al. Reduction of intraocular pressure and glaucoma progression: results from the early manifest glaucoma trial. Arch Ophthalmol. 2002;120(10):1268–1279. doi: 10.1001/archopht.120.10.1268. - DOI - PubMed
    1. Saheb H, Ahmed IIK. Micro-invasive glaucoma surgery: current perspectives and future directions. Curr Opin Ophthalmol. 2012;23(2):96–104. doi: 10.1097/ICU.0b013e32834ff1e7. - DOI - PubMed
    1. Ansari E. An update on implants for minimally invasive glaucoma surgery (MIGS). Ophthalmol Ther. 2017;6(2):233–241. doi: 10.1007/s40123-017-0098-2. - DOI - PMC - PubMed