Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2026
36-month multi-centre outcomes of XEN45 gel stent implantation in Asian versus non-Asian eyes with primary open angle glaucoma.
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Betzler Bjorn Kaijun, Ko Yu-Chieh, Trzcinski Jonathan, Chen Elizabeth Jia Hui, Helwe Hani El, Falah Henisk, Liu Catherine Jui-Ling, Chen Mei-Ju, Lentz Paul Connor, Dorairaj Syril, Valle David Solá-Del, Ang Bryan Chin Hou
Аннотация
PURPOSE: Ethnicity has been shown to influence outcomes of bleb-forming glaucoma filtering surgery. This study evaluated 3-year outcomes of XEN45 Gel Stent (XGS) in Asian versus non-Asian eyes with primary open angle glaucoma (POAG).
METHODS: This multicentre, retrospective cohort included 117 eyes with POAG undergoing XGS implantation, with or without concomitant phacoemulsification, between January 2017 and March 2023. Eyes were categorized as Asian or non-Asian based on recorded ethnicity. The primary outcome was cumulative surgical success at three years using survival analyses across intraocular pressure (IOP) thresholds (≤ 18, ≤ 15, and ≤ 12 mmHg with ≥ 20% reduction from baseline). Secondary analysis incorporating a medication reduction goal was performed. Secondary outcomes included longitudinal changes in IOP and medications, predictors of time-to-failure, and postoperative interventions and complications. Longitudinal outcomes were analysed using linear mixed-effects models. Multivariable Cox proportional hazards models evaluated predictors of failure.
RESULTS: 92 Asian and 25 non-Asian eyes were included. Both groups demonstrated sustained reductions in IOP and medication burden over 36 months. Three-year cumulative success rates were comparable between Asian and non-Asian eyes across all success definitions (AR-18: 72.2% vs. 76.5%; AR-15: 72.7% vs. 76.5%; AR-12: 68.6% vs. 63.9%; all p > 0.30). No significant differences in cumulative success were observed between Phaco-XEN and standalone XEN procedures. Ethnicity and concomitant phacoemulsification were not independently associated with time-to-failure. Post-operative interventions and complications were infrequent.
CONCLUSION: XGS demonstrated no significant differences in 3-year surgical success, safety, and durability between broadly categorized Asian and non-Asian eyes with POAG. Neither ethnicity nor concomitant phacoemulsification independently influenced failure risk.
METHODS: This multicentre, retrospective cohort included 117 eyes with POAG undergoing XGS implantation, with or without concomitant phacoemulsification, between January 2017 and March 2023. Eyes were categorized as Asian or non-Asian based on recorded ethnicity. The primary outcome was cumulative surgical success at three years using survival analyses across intraocular pressure (IOP) thresholds (≤ 18, ≤ 15, and ≤ 12 mmHg with ≥ 20% reduction from baseline). Secondary analysis incorporating a medication reduction goal was performed. Secondary outcomes included longitudinal changes in IOP and medications, predictors of time-to-failure, and postoperative interventions and complications. Longitudinal outcomes were analysed using linear mixed-effects models. Multivariable Cox proportional hazards models evaluated predictors of failure.
RESULTS: 92 Asian and 25 non-Asian eyes were included. Both groups demonstrated sustained reductions in IOP and medication burden over 36 months. Three-year cumulative success rates were comparable between Asian and non-Asian eyes across all success definitions (AR-18: 72.2% vs. 76.5%; AR-15: 72.7% vs. 76.5%; AR-12: 68.6% vs. 63.9%; all p > 0.30). No significant differences in cumulative success were observed between Phaco-XEN and standalone XEN procedures. Ethnicity and concomitant phacoemulsification were not independently associated with time-to-failure. Post-operative interventions and complications were infrequent.
CONCLUSION: XGS demonstrated no significant differences in 3-year surgical success, safety, and durability between broadly categorized Asian and non-Asian eyes with POAG. Neither ethnicity nor concomitant phacoemulsification independently influenced failure risk.