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XEN‐45 collagen implant for the treatment of uveitic glaucoma
Author(s) -
Sng Chelvin CA,
Wang Jing,
Hau Scott,
Htoon Hla Myint,
Barton Keith
Publication year - 2017
Publication title -
clinical and experimental ophthalmology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.3
H-Index - 74
eISSN - 1442-9071
pISSN - 1442-6404
DOI - 10.1111/ceo.13087
Subject(s) - medicine , glaucoma , implant , intraocular pressure , context (archaeology) , glaucoma surgery , ophthalmology , prospective cohort study , surgery , paleontology , biology
Importance The XEN‐45 implant, a hydrophilic collagen implant which drains aqueous to the subconjunctival space, has not been investigated in the context of uveitic glaucoma. Background To determine the safety and efficacy of the XEN‐45 collagen implant in eyes with uveitic glaucoma. Design Exploratory prospective case series. Participants patients with medically uncontrolled uveitic glaucoma. Methods Twenty‐four consecutive patients (mean age ± standard deviation [SD] = 45.3 ± 18.1 years) were implanted with the XEN‐45 implant. Main Outcome Measures The primary outcome measure was intraocular pressure (IOP) reduction at 12 months as compared to baseline. Secondary outcome measures included ocular hypotensive medication use at 12 months, the requirement for further glaucoma surgery and failure. Intraoperative and postoperative complications were documented. Results The baseline mean ± SD IOP was 30.5 ± 9.8 mmHg and the mean ± SD number of glaucoma medications required was 3.3 ± 0.8. In 20 eyes (83.3%) in whom conventional glaucoma surgery was originally perceived to be inevitable, further surgery was not required after XEN‐45 implantation. The mean IOP was reduced by 60.2% from baseline to 12.2 ± 3.1 mmHg and mean medication usage was reduced to 0.4 ± 0.9 at 12 months (both P < 0.001). One patient had hypotony persisting beyond 2 months that required surgical revision and one patient developed blebitis. The 12‐month cumulative Kaplan–Meier survival probability was 79.2%. Conclusions and Relevance The XEN‐45 implant is effective for the treatment of patients with medically uncontrolled uveitic glaucoma. Potentially sight‐threatening complications, including bleb‐related ocular infection and persistent hypotony, may occur.