Results of fluorouracil-augmented Xen45 implantation in primary open-angle and pseudoexfoliation glaucoma
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ORIGINAL PAPER
Results of fluorouracil-augmented Xen45 implantation in primary open-angle and pseudoexfoliation glaucoma Esin Fatma Bas¸ er
. Recep Go¨ktug˘ Seymenog˘lu
Received: 14 April 2020 / Accepted: 29 October 2020 Ó Springer Nature B.V. 2020
Abstract Purpose To report the effectiveness and safety of 5-fluorouracil (5-FU)-augmented Xen45 implantation in primary open-angle glaucoma (POAG) and pseudoexfoliation glaucoma (PEXG). Methods This single-center, retrospective chart review study included 29 eyes that underwent 5-FUaugmented Xen45 implantation. Main outcome measures were intraocular pressure (IOP) levels and number of glaucoma medications. Surgical success was defined as IOP B 21 mmHg and C 20% reduction from preoperative levels without (complete success) or with (qualified success) glaucoma medications and without further glaucoma surgery at last follow-up. All postoperative interventions and complications were also noted. Results The mean age of the patients was 67.5 ± 10.3 years, and the mean follow-up time was 23.2 ± 12.6 months. Mean IOP was 24.5 ± 8.7 mmHg and decreased by 30.2% at 12 months, 24.9% at 24 months, and 31.7% at final visit (p \ 0.001, p = 0.006, p [ 0.001, respectively). Mean number of glaucoma medications decreased from 2.83 preoperatively to 0.71 at 12 months, 0.87 at 24 months, and 0.86 at final visit (p \ 0.001). At final visit, the complete success rate was 48.3%, qualified E. F. Bas¸ er (&) R. G. Seymenog˘lu Department of Ophthalmology, Kars¸ ıyaka Eye Hospital, Caher Dudayev Bulv. No:71, 35550 ˙Izmir, Turkey e-mail: [email protected]
success rate was 69%, and 62.1% of the eyes were free of glaucoma medications. Needling was performed in 7 eyes (24%). Adverse events included choroidal detachment in 5 eyes, hyphema in 2 eyes, and endophthalmitis in 1 eye. Conclusion 5-FU-augmented Xen45 implantation in POAG and PEXG patients provided safe and effective IOP lowering with significant reduction of glaucoma medications up to 3 years. Keywords Fluorouracil MIGS Open-angle glaucoma Pseudoexfoliation glaucoma Xen Introduction Glaucoma is one of the leading causes of blindness worldwide, and the main treatment is effective lowering of intraocular pressure (IOP). This is typically achieved using IOP-lowering medications, lasers, and surgical procedures. Traditional filtration surgery is usually reserved for advanced and progressive glaucoma. Although highly efficient, trabeculectomy and tube shunts cause many intraoperative and postoperative complications, some of which are sight-threatening [1]. Minimally invasive glaucoma surgery (MIGS) represents a new era in glaucoma surgery and is mainly performed by an ab interno microincisional approach, enhancing physiologic outflow with minimal anatomic disruption, high safety profile, and
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fast recovery. Many MIGS procedures can be combined with cataract surgery [2–4]. Xen45 (Allergan, Irvine, CA, USA) is a collagenbased gel implant 6 mm in length with an inte
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