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Results of open bleb revision as management of primary bleb failure following XEN 45 gel stent and Preserflo™ Microshunt
PURPOSE: The success of filtering surgery as in XEN-Gel-Stent (XEN) and Preserflo-Microshunt (PF) depends mainly on a functioning bleb. Primary bleb failure (PBF) is not uncommon and can be treated with needling or open bleb revision (OBR). The aim of the study is to compare surgical outcomes of OBR...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10587268/ https://www.ncbi.nlm.nih.gov/pubmed/37410178 http://dx.doi.org/10.1007/s00417-023-06152-8 |
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author | Theilig, Theresa Papadimitriou, Menelaos Albaba, Ghaith Meller, Daniel Hasan, Somar M. |
author_facet | Theilig, Theresa Papadimitriou, Menelaos Albaba, Ghaith Meller, Daniel Hasan, Somar M. |
author_sort | Theilig, Theresa |
collection | PubMed |
description | PURPOSE: The success of filtering surgery as in XEN-Gel-Stent (XEN) and Preserflo-Microshunt (PF) depends mainly on a functioning bleb. Primary bleb failure (PBF) is not uncommon and can be treated with needling or open bleb revision (OBR). The aim of the study is to compare surgical outcomes of OBR after XEN and PF. METHODS: Eyes which received OBR as management of PBF following implantation of XEN or PF were retrospectively included. Intraocular pressure (IOP), number of IOP lowering medications (NoM), and success rates (SR) were compared between groups. Complete and qualified success were defined as IOP ≤18mmHg and a reduction of >20%, without and with medications, respectively. RESULTS: 29 eyes after XEN and 23 eyes after PF were included. Six months following OBR, IOP reduced from 24.2±4.7 to 13.5±4.6 after XEN and from 27.3±8.7 to 15.9±5.8mmHg after PF (both p<0.001). NoM did not change (0.7±1.3 to 0.4±0.8 after XEN and 1.2±1.3 to 1.0±1.5 after PF, p>0.05 for both). Complete SR were higher after XEN than after PF (58.6% vs. 30.4%, p=0.04). Complications were mild and managed mainly conservatively. Additional glaucoma surgery was needed in 17% and 30% of eyes after XEN and PF, respectively (p=0.26). CONCLUSION: Although OBR was effective as management of PBF following XEN and PF, SR were higher after XEN than after PF along with comparable safety profile. The change of the surgical approach from ab interno during XEN-Implantation to ab externo during OBR seems to enhance SR compared to PF, where both interventions are done ab externo. |
format | Online Article Text |
id | pubmed-10587268 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-105872682023-10-21 Results of open bleb revision as management of primary bleb failure following XEN 45 gel stent and Preserflo™ Microshunt Theilig, Theresa Papadimitriou, Menelaos Albaba, Ghaith Meller, Daniel Hasan, Somar M. Graefes Arch Clin Exp Ophthalmol Glaucoma PURPOSE: The success of filtering surgery as in XEN-Gel-Stent (XEN) and Preserflo-Microshunt (PF) depends mainly on a functioning bleb. Primary bleb failure (PBF) is not uncommon and can be treated with needling or open bleb revision (OBR). The aim of the study is to compare surgical outcomes of OBR after XEN and PF. METHODS: Eyes which received OBR as management of PBF following implantation of XEN or PF were retrospectively included. Intraocular pressure (IOP), number of IOP lowering medications (NoM), and success rates (SR) were compared between groups. Complete and qualified success were defined as IOP ≤18mmHg and a reduction of >20%, without and with medications, respectively. RESULTS: 29 eyes after XEN and 23 eyes after PF were included. Six months following OBR, IOP reduced from 24.2±4.7 to 13.5±4.6 after XEN and from 27.3±8.7 to 15.9±5.8mmHg after PF (both p<0.001). NoM did not change (0.7±1.3 to 0.4±0.8 after XEN and 1.2±1.3 to 1.0±1.5 after PF, p>0.05 for both). Complete SR were higher after XEN than after PF (58.6% vs. 30.4%, p=0.04). Complications were mild and managed mainly conservatively. Additional glaucoma surgery was needed in 17% and 30% of eyes after XEN and PF, respectively (p=0.26). CONCLUSION: Although OBR was effective as management of PBF following XEN and PF, SR were higher after XEN than after PF along with comparable safety profile. The change of the surgical approach from ab interno during XEN-Implantation to ab externo during OBR seems to enhance SR compared to PF, where both interventions are done ab externo. Springer Berlin Heidelberg 2023-07-06 2023 /pmc/articles/PMC10587268/ /pubmed/37410178 http://dx.doi.org/10.1007/s00417-023-06152-8 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Glaucoma Theilig, Theresa Papadimitriou, Menelaos Albaba, Ghaith Meller, Daniel Hasan, Somar M. Results of open bleb revision as management of primary bleb failure following XEN 45 gel stent and Preserflo™ Microshunt |
title | Results of open bleb revision as management of primary bleb failure following XEN 45 gel stent and Preserflo™ Microshunt |
title_full | Results of open bleb revision as management of primary bleb failure following XEN 45 gel stent and Preserflo™ Microshunt |
title_fullStr | Results of open bleb revision as management of primary bleb failure following XEN 45 gel stent and Preserflo™ Microshunt |
title_full_unstemmed | Results of open bleb revision as management of primary bleb failure following XEN 45 gel stent and Preserflo™ Microshunt |
title_short | Results of open bleb revision as management of primary bleb failure following XEN 45 gel stent and Preserflo™ Microshunt |
title_sort | results of open bleb revision as management of primary bleb failure following xen 45 gel stent and preserflo™ microshunt |
topic | Glaucoma |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10587268/ https://www.ncbi.nlm.nih.gov/pubmed/37410178 http://dx.doi.org/10.1007/s00417-023-06152-8 |
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