Skip to main content

Advertisement

SpringerLink
Log in

XEN gel implant versus gonioscopy-assisted transluminal trabeculotomy for the treatment of open-angle glaucoma

  • Original Paper
  • Published:
International Ophthalmology Aims and scope Submit manuscript

Abstract

Objectives

To compare successes and complications of XEN GEL Stent implantation and gonioscopy-assisted transluminal trabeculotomy (GATT) surgery in patients with open-angle glaucoma (OAG).

Methods

The multicentre, non-randomized, comparative, interventional, retrospective chart review study included 114 eyes undergoing XEN implantation and 107 eyes undergoing GATT for treatment of OAG. A comprehensive ophthalmic examination consisting of best-corrected LogMAR visual acuity (BCVA), Goldmann Applanation Tonometry, biomicroscopy, fundoscopy and gonioscopy was performed, and then, clinical findings, complications and number of antiglaucomatous medications were noted at the 3-, 6-, 12-, 18- and 24-month postoperative visits. Surgical success was defined as IOP ≤ 21 mmHg and 20% ≥ IOP reduction from baseline with (qualified success) or without (complete success) further medication, and without any further IOP-lowering surgery.

Results

The mean ages were 65.8 ± 10.6 and 59.1 ± 14.3 in XEN and GATT groups, respectively (p = 0.001). In XEN group, the percentage of IOP reduction and need of medication were significantly more improved than those in GATT group. The complete surgical success rates were 34.2% and 50.5% in XEN and GATT groups, respectively (p = 0.039), with a success rate of 41.1% in total. Qualified surgical success rates were 97.4% and 89.7% in XEN and GATT groups, respectively (p = 0.025), with a success rate of 93.7% in total. Transient hyphema, the most observed postoperative complication in both groups, cleared in a few days.

Conclusions

Both MIGS have good efficacy and safety outcomes in lowering IOP and need of medication in patients with OAG. XEN Gel Stent implantation may be preferred in patients with lower IOP values targeted.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Tham YC, Li X, Wong TY, Quigley HA, Aung T, Cheng CY (2014) Global prevalence of glaucoma and projections of glaucoma burden through 2040: a systematic review and meta-analysis. Ophthalmology 121(11):2081–2090

    Article  PubMed  Google Scholar 

  2. Richter GM, Coleman AL (2016) Minimally invasive glaucoma surgery: current status and future prospects. Clin Ophthalmol 10:189–206

    PubMed  PubMed Central  Google Scholar 

  3. Heijl A, Leske MC, Bengtsson B, Hyman L, Bengtsson B, Hussein M, Early Manifest Glaucoma Trial G (2002) Reduction of intraocular pressure and glaucoma progression: results from the early manifest glaucoma trial. Arch Ophthalmol 120(10):1268–1279

    Article  PubMed  Google Scholar 

  4. Lemij HG, Hoevenaars JG, van der Windt C, Baudouin C (2015) Patient satisfaction with glaucoma therapy: reality or myth? Clin Ophthalmol 9:785–793

    PubMed  PubMed Central  Google Scholar 

  5. Kerr NM, Wang J, Barton K (2017) Minimally invasive glaucoma surgery as primary stand-alone surgery for glaucoma. Clin Exp Ophthalmol 45(4):393–400

    Article  PubMed  Google Scholar 

  6. Gedde SJ, Herndon LW, Brandt JD, Budenz DL, Feuer WJ, Schiffman JC, Tube Versus Trabeculectomy Study G (2012) Postoperative complications in the tube versus trabeculectomy (tvt) study during five years of follow-up. Am J Ophthalmol 153(5):804–814e801

    Article  PubMed  PubMed Central  Google Scholar 

  7. Vera VI, Horvath C (2014) Xen gel stent: The solution designed by aquesys®. Surgical innovations in glaucoma. Springer, Berlin, pp 189–198

    Book  Google Scholar 

  8. Reitsamer H, Sng C, Vera V, Lenzhofer M, Barton K, Stalmans I, Apex Study G (2019) Two-year results of a multicenter study of the ab interno gelatin implant in medically uncontrolled primary open-angle glaucoma. Graefes Arch Clin Exp Ophthalmol 257(5):983–996

    Article  CAS  PubMed  Google Scholar 

  9. Grover DS, Fellman RL (2016) Gonioscopy-assisted transluminal trabeculotomy (gatt): thermal suture modification with a dye-stained rounded tip. J Glaucoma 25(6):501–504

    Article  PubMed  Google Scholar 

  10. Musch DC, Gillespie BW, Niziol LM, Lichter PR, Varma R, Group CS (2011) Intraocular pressure control and long-term visual field loss in the collaborative initial glaucoma treatment study. Ophthalmology 118(9):1766–1773

    Article  PubMed  PubMed Central  Google Scholar 

  11. Gedde SJ, Schiffman JC, Feuer WJ, Herndon LW, Brandt JD, Budenz DL, Tube versus Trabeculectomy Study G (2012) Treatment outcomes in the tube versus trabeculectomy (tvt) study after five years of follow-up. Am J Ophthalmol 153(5):789–803.e782

    Article  PubMed  PubMed Central  Google Scholar 

  12. Rahmatnejad K, Pruzan NL, Amanullah S, Shaukat BA, Resende AF, Waisbourd M, Zhan T, Moster MR (2017) Surgical outcomes of gonioscopy-assisted transluminal trabeculotomy (gatt) in patients with open-angle glaucoma. J Glaucoma 26(12):1137–1143

    Article  PubMed  Google Scholar 

  13. Widder RA, Dietlein TS, Dinslage S, Kuhnrich P, Rennings C, Rossler G (2018) The xen45 gel stent as a minimally invasive procedure in glaucoma surgery: success rates, risk profile, and rates of re-surgery after 261 surgeries. Graefes Arch Clin Exp Ophthalmol 256(4):765–771

    Article  PubMed  Google Scholar 

  14. Heidinger A, Schwab C, Lindner E, Riedl R, Mossbock G (2019) A retrospective study of 199 xen45 stent implantations from 2014 to 2016. J Glaucoma 28(1):75–79

    Article  PubMed  Google Scholar 

  15. Schlenker MB, Gulamhusein H, Conrad-Hengerer I, Somers A, Lenzhofer M, Stalmans I, Reitsamer H, Hengerer FH, Ahmed IIK (2017) Efficacy, safety, and risk factors for failure of standalone ab interno gelatin microstent implantation versus standalone trabeculectomy. Ophthalmology 124(11):1579–1588

    Article  PubMed  Google Scholar 

  16. Grover DS, Flynn WJ, Bashford KP, Lewis RA, Duh YJ, Nangia RS, Niksch B (2017) Performance and safety of a new ab interno gelatin stent in refractory glaucoma at 12 months. Am J Ophthalmol 183:25–36

    Article  PubMed  Google Scholar 

  17. Olgun A, Imamoglu S, Karapapak M, Duzgun E, Kacar H (2018) Endophthalmitis after xen gel stent implantation: 2 cases. J Glaucoma 27(12):e191–e194

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

None.

Funding

None.

Author information

Authors and Affiliations

  1. Dunya Goz Altunizade, Istanbul, Turkey

    Ali Olgun

  2. Department of Ophthalmology, Gazi University Faculty of Medicine, Ankara, Turkey

    Zeynep Aktas

  3. Izzet Baysal Training and Research Hospital, Abant Izzet Baysal University, Kılıçarslan Mah. 144. Sk No: 6, Merkez, Bolu, Turkey

    Ahmet Yucel Ucgul

Authors
  1. Ali Olgun
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Zeynep Aktas
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ahmet Yucel Ucgul
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ahmet Yucel Ucgul.

Ethics declarations

Conflict of interest

None of the authors of this paper has a financial or personal relationship with other people or organizations that could inappropriately influence or bias the content of the paper. It is to specifically state “No Competing interests are at stake and there is No Conflict of Interest” with other people or organizations that could inappropriately influence or bias the content of the paper.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Olgun, A., Aktas, Z. & Ucgul, A.Y. XEN gel implant versus gonioscopy-assisted transluminal trabeculotomy for the treatment of open-angle glaucoma. Int Ophthalmol 40, 1085–1093 (2020). https://doi.org/10.1007/s10792-019-01271-w

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10792-019-01271-w

Keywords

Search

Navigation