Outcomes of 45 μm gelatin stent surgery over 24-month follow-up.

BACKGROUND

The main objectives of this study were to determine whether known risk factors for trabeculectomy failure similarly influence gelatin stent outcomes and to identify surgical factors which may optimise success.

METHODS

A retrospective, observational study was conducted at a single centre in Perth, Western Australia over 24 months. Two-hundred and sixty-two eyes of 207 patients underwent XEN-45 stent surgery with various forms of glaucoma. Surgical and postoperative data on subjects undergoing XEN-45 stent surgery was collated. Intraocular pressure (IOP) reduction success was determined using three criteria: 1; IOP <18 mm Hg, 2: IOP <15 mm Hg and 3: >25% IOP reduction from baseline. Kaplan-Meier, mixed effects Cox Proportional hazard model and Chi-Square test were used to measure survival of functioning stents.

RESULTS

The success rates at a maximum of 2 years after surgery by criteria 1, 2 and 3 were 61.3%, 26.2% and 28.9% in primary open angle glaucoma (n = 243), 18.8%, 16.9%, 21.4% in angle closure glaucoma (n = 11), 0%, 0%, 66.7% in congenital glaucoma (n = 5) and 0% in uveitic glaucoma (n = 3). No significant reduction in success was found in those eyes that had prior ocular surgery (all p > 0.07).

CONCLUSIONS

Prior cataract or trabeculectomy surgery does not appear to adversely affect gelatin stent outcomes over 2 years follow up. Gelatin stent surgery appears to have less IOP reduction effect compared to trabeculectomy at 2 years.