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Effectiveness and Safety of Xen Gel Stent in Glaucoma Surgery: A Systematic Review of the Literature

Although topical medical therapy and selective-laser-trabeculoplasty represent the treatments of choice to reduce intraocular pressure, many patients do not achieve adequate glaucoma control; therefore, they require further options and eventually surgery. Trabeculectomy is still considered the gold...

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Autores principales: Traverso, Carlo Enrico, Carassa, Roberto G., Fea, Antonio Maria, Figus, Michele, Astarita, Carlo, Piergentili, Benedetta, Vera, Vanessa, Gandolfi, Stefano
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10455777/
https://www.ncbi.nlm.nih.gov/pubmed/37629380
http://dx.doi.org/10.3390/jcm12165339
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author Traverso, Carlo Enrico
Carassa, Roberto G.
Fea, Antonio Maria
Figus, Michele
Astarita, Carlo
Piergentili, Benedetta
Vera, Vanessa
Gandolfi, Stefano
author_facet Traverso, Carlo Enrico
Carassa, Roberto G.
Fea, Antonio Maria
Figus, Michele
Astarita, Carlo
Piergentili, Benedetta
Vera, Vanessa
Gandolfi, Stefano
author_sort Traverso, Carlo Enrico
collection PubMed
description Although topical medical therapy and selective-laser-trabeculoplasty represent the treatments of choice to reduce intraocular pressure, many patients do not achieve adequate glaucoma control; therefore, they require further options and eventually surgery. Trabeculectomy is still considered the gold standard, but the surgical management of glaucoma has undergone continuous advances in recent years, XEN-gel-stent has been introduced as a safer and less traumatic means of lowering intraocular pressure (IOP) in patients with open-angle glaucoma (OAG). This study aimed to review the effectiveness and safety of clinical data on XEN-stent in OAG patients with a Synthesis-Without-Meta-analysis (SWiM) methodology. A total of 339 studies were identified following a literature search adhering to PRISMA guidelines and, after evaluation, 96 studies are discussed. XEN63 and XEN45 device data were collected both short and long term. In addition, this document has evaluated different aspects related to the XEN implant, including: its role compared to trabeculectomy; the impact of mitomycin-C dose on clinical outcomes; postoperative management of the device; and the identification of potential factors that might predict its clinical outcomes. Finally, current challenges and future perspectives of XEN stent, such as its use in fragile or high myopia patients, were discussed.
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spelling pubmed-104557772023-08-26 Effectiveness and Safety of Xen Gel Stent in Glaucoma Surgery: A Systematic Review of the Literature Traverso, Carlo Enrico Carassa, Roberto G. Fea, Antonio Maria Figus, Michele Astarita, Carlo Piergentili, Benedetta Vera, Vanessa Gandolfi, Stefano J Clin Med Review Although topical medical therapy and selective-laser-trabeculoplasty represent the treatments of choice to reduce intraocular pressure, many patients do not achieve adequate glaucoma control; therefore, they require further options and eventually surgery. Trabeculectomy is still considered the gold standard, but the surgical management of glaucoma has undergone continuous advances in recent years, XEN-gel-stent has been introduced as a safer and less traumatic means of lowering intraocular pressure (IOP) in patients with open-angle glaucoma (OAG). This study aimed to review the effectiveness and safety of clinical data on XEN-stent in OAG patients with a Synthesis-Without-Meta-analysis (SWiM) methodology. A total of 339 studies were identified following a literature search adhering to PRISMA guidelines and, after evaluation, 96 studies are discussed. XEN63 and XEN45 device data were collected both short and long term. In addition, this document has evaluated different aspects related to the XEN implant, including: its role compared to trabeculectomy; the impact of mitomycin-C dose on clinical outcomes; postoperative management of the device; and the identification of potential factors that might predict its clinical outcomes. Finally, current challenges and future perspectives of XEN stent, such as its use in fragile or high myopia patients, were discussed. MDPI 2023-08-16 /pmc/articles/PMC10455777/ /pubmed/37629380 http://dx.doi.org/10.3390/jcm12165339 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Traverso, Carlo Enrico
Carassa, Roberto G.
Fea, Antonio Maria
Figus, Michele
Astarita, Carlo
Piergentili, Benedetta
Vera, Vanessa
Gandolfi, Stefano
Effectiveness and Safety of Xen Gel Stent in Glaucoma Surgery: A Systematic Review of the Literature
title Effectiveness and Safety of Xen Gel Stent in Glaucoma Surgery: A Systematic Review of the Literature
title_full Effectiveness and Safety of Xen Gel Stent in Glaucoma Surgery: A Systematic Review of the Literature
title_fullStr Effectiveness and Safety of Xen Gel Stent in Glaucoma Surgery: A Systematic Review of the Literature
title_full_unstemmed Effectiveness and Safety of Xen Gel Stent in Glaucoma Surgery: A Systematic Review of the Literature
title_short Effectiveness and Safety of Xen Gel Stent in Glaucoma Surgery: A Systematic Review of the Literature
title_sort effectiveness and safety of xen gel stent in glaucoma surgery: a systematic review of the literature
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10455777/
https://www.ncbi.nlm.nih.gov/pubmed/37629380
http://dx.doi.org/10.3390/jcm12165339
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