Standalone XEN45 Gel Stent implantation in the treatment of open-angle glaucoma: A systematic review and meta-analysis

The XEN45 Gel Stent (Allergan Inc., Irvine, CA) allows the drainage of aqueous into the sub-conjunctival space, through a minimally-invasive approach. This systematic review and meta-analysis evaluates its intraocular pressure (IOP)-lowering efficacy and complications in the treatment of open-angle...

Full description

Saved in:
Bibliographic Details
Published in:Survey of ophthalmology 2022-07, Vol.67 (4), p.1048-1061
Main Authors: Lim, Sheng Yang, Betzler, Bjorn Kaijun, Yip, Leonard Wei Leon, Dorairaj, Syril, Ang, Bryan Chin Hou
Format: Article
Language:English
Subjects:
Glaucoma Drainage Implants
Glaucoma, Open-Angle - surgery
Humans
Intraocular Pressure
Meta-analysis
Minimally invasive glaucoma surgery
Open angle glaucoma
Stents
Systematic review
Tonometry, Ocular
Treatment Outcome
XEN45
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:The XEN45 Gel Stent (Allergan Inc., Irvine, CA) allows the drainage of aqueous into the sub-conjunctival space, through a minimally-invasive approach. This systematic review and meta-analysis evaluates its intraocular pressure (IOP)-lowering efficacy and complications in the treatment of open-angle glaucoma. Fourteen studies comprising 963 eyes were included. IOP decreased significantly (P < 0.001) across all timepoints (1 day, 1 week, 1, 3, 6, 12, 18, and 24 months) with a mean decrease of 7.44 mm Hg (95%CI:4.91–9.97) at 24 months. IOP-lowering medications decreased significantly (P < 0.001) across all timepoints (1 week, 1, 3, 6, 12, 18, 24 months) with a mean reduction of 1.67 medications (95%CI:1.28–2.06) at 24 months. Numerical hypotony occurred in 39% (95%CI:14%–67%) and stent exposure in 1% (95%CI:0%–2%) of eyes. 38% (95%CI:30%–46%) of eyes required at least one postoperative needling, with an average of 0.6 (95%CI:0.37–0.81) needlings per eye. Standalone XEN45 Gel Stent implantation is effective in lowering IOP in open-angle glaucoma. Transient numerical hypotony is the most common postoperative complication. Sight-threatening complications are rare. Postoperative needling may be required to maintain IOP-lowering outcomes; however, the overall quality of current evidence is low, with the need for more randomized controlled trials and outcomes measured with a clinically meaningful definition of success.
ISSN:0039-6257
1879-3304
DOI:10.1016/j.survophthal.2022.01.003