en
Scientific article
English

Bilateral XEN stent implantation: a long-term prospective study of the difference in outcomes between first-operated and fellow eyes

Published inJournal of Glaucoma, vol. 29, no. 7, p. 536-541
Publication date2020
Abstract

Background/Aims: Both eyes of a same person are not completely independent entities. The purpose of this study was to assess the difference in outcome between the first-operated eye and the fellow-operated eye following bilateral XEN surgery, and to identify potential success predictors for the fellow eye. Methods: This single-site, prospective, nonrandomized interventional study investigated bilateral nonsimultaneous XEN gel stent implantation over 24 months. Its main outcome measure was surgical success, defined as unmedicated intraocular pressure (IOP) <= 15 mm Hg associated with a relative reduction >= 20%. Results: Of 149 enrolled eyes, 74 eyes of 37 patients who underwent bilateral (standalone or combined) XEN implantation, within a mean of 50.5 +/- 74.3 days of each other, were analyzed. Postoperatively, mean medicated IOP decreased from 19.0 +/- 6.6 (first-operated) and 18.2 +/- 5.2 mm Hg (fellow) at baseline (P=0.209) to 13.7 +/- 4.0 (-27.9%;P<0.001; first-operated) and 14.1 +/- 3.6 mm Hg (-22.5%;P<0.001; fellow) after 2 years (P=0.673). Rates of complete success were comparable between first-operated and fellow eyes (P=0.65). At 2 years, among patients whose first-operated eyes were considered a failure, 92.0% of fellow eyes failed (P=0.001). The odd ratio of a fellow eye experiencing complete success were 16.1 (95% confidence interval: 2.5-101.9,P=0.003) if the first operated eye experienced complete success. Conclusions: The present study demonstrated a strong association between first-operated eyes and fellow eyes following XEN gel stent implantation, in terms of surgical outcomes and IOP reduction. In effect, surgical success in the first-operated eye increases the odds of success in the fellow eye by 16-folds.

Keywords
  • Aged
  • Aged
  • 80 and over
  • Female
  • Glaucoma Drainage Implants
  • Glaucoma
  • Open-Angle/physiopathology/surgery
  • Humans
  • Intraocular Pressure/physiology
  • Male
  • Odds Ratio
  • Outcome Assessment
  • Health Care
  • Postoperative Period
  • Prospective Studies
  • Prosthesis Implantation
  • Tonometry
  • Ocular
  • Visual Acuity/physiology
Affiliation Not a UNIGE publication
Citation (ISO format)
GILLMANN, Kevin et al. Bilateral XEN stent implantation: a long-term prospective study of the difference in outcomes between first-operated and fellow eyes. In: Journal of Glaucoma, 2020, vol. 29, n° 7, p. 536–541. doi: 10.1097/IJG.0000000000001520
Main files (1)
Article (Published version)
accessLevelRestricted
Identifiers
ISSN of the journal1057-0829
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Creation01/14/2021 12:15:00 PM
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Update time03/15/2023 11:53:09 PM
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