Efficacy of the XEN-Implant in Glaucoma and a Meta-Analysis of the Literature

• Published in: Journal of clinical medicine 2021-03, Vol.10 (5), p.1118
• Main Authors: Poelman, Huub J, Pals, Jan, Rostamzad, Parinaz, Bramer, Wichor M, Wolfs, Roger C W, Ramdas, Wishal D
• Format: Article
• Language: English
• Subjects: Cataracts; Clinical medicine; Eye surgery; Glaucoma; Meta-analysis; Patients; Surgical techniques; Systematic review; Transplants & implants; Variables
• ISSN: 2077-0383; 2077-0383
• DOI: 10.3390/jcm10051118

To assess the efficacy of XEN-implant surgery in patients with glaucoma, and to perform a meta-analysis of previously published results and compare these to our data. Prospective case-control study, in which all eyes that underwent XEN-implant surgery were included from 2015 onwards. Sub-analyses were performed for eyes that underwent XEN-implant as standalone procedure and as cataract-combined procedure. To compare our results, a systematic review was performed using the Embase, PubMed, Web of Science, and Cochrane database. Meta-analyses were performed by combining data (intraocular pressure (IOP), IOP-lowering medication, and complications) from the retrieved studies. A total of 221 eyes underwent XEN-implant surgery (124 standalone and 97 cataract-combined). The mean ± standard deviation IOP declined from 18.8 ± 6.5 to 13.5 ± 4.3 mmHg at the last follow-up ( < 0.001; 28.9%). Postoperative, no significant differences in IOP or IOP-lowering medication were found between patients with and without combined procedure. Secondary surgeries were performed in 20.8% of eyes, most of them (63.0%) within six months. A meta-analysis of 19 studies retrieved from the systematic review showed a two-years postoperative pooled mean (weighted mean difference) of 14.5 (7.3) mmHg and 1.0 (1.6) for IOP and IOP-lowering medications, respectively (compared to 13.5 (5.3) mmHg and 3.2 (2.4) in the current study). XEN-implant surgery was effective and safe in lowering IOP and the number of IOP-lowering medications. There were no differences between standalone and combined procedures.