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Case Series of Combined XEN Implantation and Phacoemulsification in Chinese Eyes: One-Year Outcomes

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Abstract

Purpose

The outcome of XEN implantation in Chinese eyes has not been previously reported. The purpose of our study is to evaluate the efficacy and safety of combined cataract surgery and XEN implantation in Chinese eyes with glaucoma.

Methods

We conducted a prospective study of 31 consecutive Chinese patients who underwent combined phacoemulsification and XEN implantation at the National University Hospital (Singapore) in this study. Patients were assessed preoperatively and postoperatively on days 1 and 7, and months 1, 3, 6, and 12. The intraocular pressure (IOP), glaucoma medication use, Snellen visual acuity (VA), and complications were assessed at each visit. The Wilcoxon signed rank test for non-parametric data was used for the analysis of IOP and glaucoma medications at baseline versus 12 months after the procedure.

Results

The mean age of the patients was 70 ± 7.9 years and 48.4% were male. Twelve patients (38.7%) were diagnosed with primary open angle glaucoma and 19 patients (61.3%) were diagnosed with primary angle closure glaucoma. There was a significant decrease in IOP at 12 months (12.1 ± 2.6 mmHg) compared with preoperative medicated (15.6 ± 2.7 mmHg, p < 0.0001) and unmedicated IOP (22.1 ± 3.6 mmHg, p < 0.001). as well as a significant reduction in the number of glaucoma medications (1.4 ± 0.6 vs 0.1 ± 0.4, p < 0.0001). The most common complications were transient hypotony (12.9%) and ptosis (12.9%) and there were no sight-threatening intraoperative or postoperative complications. One patient required additional glaucoma surgery for uncontrolled IOP at 8 months after combined phacoemulsification and XEN implantation.

Conclusion

Combined XEN implantation with cataract surgery was effective in lowering the IOP and the number of glaucoma medications in Chinese eyes for at least 12 months, with a favorable safety profile.

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Acknowledgements

Funding

This study and the journal’s Rapid Service Fees were funded by an endowment from the Lee Foundation (Singapore).

Authorship

All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, had full access to all of the data in this study, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published.

Disclosures

Chelvin C. A. Sng is a consultant for Alcon, Allergan, and Santen and has also received research and travel funding from Glaukos and Allergan. Marcus Ang is a consultant for Allergan, Ziemer, Zeiss, and Johnson & Johnson. Paul T. K. Chew, Hla Myint Htoon, Katherine Lun and Preethi Jeyabal have nothing to declare.

Compliance with Ethics Guidelines

This study was approved by the National Healthcare Group Domain Specific Review Board. Informed consent was obtained from all subjects before recruitment into this study.

Data Availability

The data sets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

Author information

Authors and Affiliations

  1. Department of Ophthalmology, National University Hospital, Singapore, Singapore

    Chelvin C. A. Sng, Paul T. K. Chew, Katherine Lun & Preethi Jeyabal

  2. Singapore Eye Research Institute, Singapore, Singapore

    Chelvin C. A. Sng, Hla Myint Htoon & Marcus Ang

  3. Singapore National Eye Center, Singapore, Singapore

    Marcus Ang

Authors
  1. Chelvin C. A. Sng
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  2. Paul T. K. Chew
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  3. Hla Myint Htoon
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  4. Katherine Lun
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  5. Preethi Jeyabal
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  6. Marcus Ang
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Corresponding author

Correspondence to Chelvin C. A. Sng.

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Sng, C.C.A., Chew, P.T.K., Htoon, H.M. et al. Case Series of Combined XEN Implantation and Phacoemulsification in Chinese Eyes: One-Year Outcomes. Adv Ther 36, 3519–3529 (2019). https://doi.org/10.1007/s12325-019-01127-w

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  • DOI: https://doi.org/10.1007/s12325-019-01127-w

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