Navigating hypotony challenges with XEN gel implantation

References

• De Gregorio A, Montali M, Stevan G, et al. Theoretic scientific rationale of double XEN 45 gel stent implant in severe glaucomatous ocular hypertension. Int Ophthalmol. 2023;43(5):1629–1638. doi: 10.1007/s10792-022-02561-6
   PubMed Web of Science ®Google Scholar
• Au L, Stalmans I. XEN Gel Implant. In: Sng CCA Barton K, editors. Minimally invasive glaucoma surgery. Singapore: Springer; 2021. DOI:10.1007/978-981-15-5632-6_6
   Google Scholar
• Green W, Lind JT, Sheybani A. Review of the Xen Gel Stent and InnFocus MicroShunt. Curr Opin Ophthalmol. 2018 Mar;29(2):162–170. doi: 10.1097/ICU.0000000000000462
   PubMed Web of Science ®Google Scholar
• Kong YXG, Chung IY, Ang GS. Outcomes of XEN45 gel stent using posterior small incision sub-tenon ab interno insertion (semi-open) technique. Eye (Lond). 2022;36(7):1456–1460. doi: 10.1038/s41433-021-01635-6
   PubMed Web of Science ®Google Scholar
• Gallardo MJ, Vincent LR, Porter M. Comparison of clinical outcomes following gel stent implantation via Ab-Externo and Ab-interno approaches in patients with refractory glaucoma. Clin Ophthalmol. 2022 [Published 2022 Jul 6];16:2187–2197. doi: 10.2147/OPTH.S354038
   PubMed Web of Science ®Google Scholar
• Yuan L, Rana HS, Lee I, et al. Short-Term Outcomes of Xen-45 Gel Stent Ab Interno Versus Ab Externo Transconjunctival Approaches. J Glaucoma. 2023;32(7):e71–e79. doi: 10.1097/IJG.0000000000002208
   PubMed Web of Science ®Google Scholar
• Ruda RC, Yuan L, Lai GM, et al. Clinical outcomes of ab interno placement versus ab externo placement of XEN45 gel stents. Ophthalmol Glaucoma. 2023;6(1):4–10. doi: 10.1016/j.ogla.2022.07.002
   PubMedGoogle Scholar
• Tan NE, Tracer N, Terraciano A, et al. Comparison of safety and efficacy between ab interno and ab externo approaches to XEN gel stent placement. Clin Ophthalmol. 2021 Jan 26. [ Published 2021];15:299–305. 10.2147/OPTH.S292007.
   PubMed Web of Science ®Google Scholar
• Chen XZ, Liang ZQ, Yang KY, et al. The outcomes of XEN gel stent implantation: a systematic review and meta-analysis. Front Med. 2022 [Published 2022 Feb 4];9:804847.
   Google Scholar
• Reitsamer H, Vera V, Ruben S, et al. Three-year effectiveness and safety of the XEN gel stent as a solo procedure or in combination with phacoemulsification in open-angle glaucoma: a multicentre study. Acta Ophthalmol. 2022;100(1):e233–e245.
   PubMed Web of Science ®Google Scholar
• Hussein IM, De Francesco T, Ahmed IIK. Intermediate outcomes of the novel 63-μm gelatin microstent versus the conventional 45-μm gelatin microstent [published online ahead of print, 2023 May 9]. Ophthalmol Glaucoma. 2023;6(6):580–591. S2589-4196(23)00078-9. doi: 10.1016/j.ogla.2023.05.001.
   PubMedGoogle Scholar
• Clement CI, Chua B, Yun S. Does chronic hypotony following trabeculectomy represent treatment failure? J Curr Glaucoma Pract. 2015;9(1):12–15. doi: 10.5005/jp-journals-10008-1176
   PubMedGoogle Scholar
• Krupin T, Liebmann J, Sokol J. Therapeutics and Techniques. J Glaucoma. 1996;5(3):210–220. doi: 10.1097/00061198-199606000-00012
   PubMedGoogle Scholar
• Yun ST, Chua B, Clement CI. Outcomes of chronic hypotony following trabeculectomy. Clin Exp Ophthalmol. 2015;43(5):485–487. doi: 10.1111/ceo.12481
   PubMed Web of Science ®Google Scholar
• Galimi ME, Weller JM, Kruse FE, et al. Risk factors for ocular hypotony after XEN Gel Stent implantation. Graefes Arch Clin Exp Ophthalmol. 2023;261(3):769–778. doi: 10.1007/s00417-022-05831-2
   PubMed Web of Science ®Google Scholar
• Reitsamer H, Sng C, Vera V, et al. Two-year results of a multicenter study of the ab interno gelatin implant in medically uncontrolled primary open-angle glaucoma. Graefes Arch Clin Exp Ophthalmol. 2019;257(5):983–996. doi: 10.1007/s00417-019-04251-z
   PubMed Web of Science ®Google Scholar
• Scheres LMJ, Kujovic-Aleksov S, Ramdas WD, et al. XEN® gel stent compared to PRESERFLO™ MicroShunt implantation for primary open-angle glaucoma: two-year results. Acta Ophthalmol. 2021;99(3):e433–e440.
   PubMed Web of Science ®Google Scholar
• Gillmann K, Bravetti GE, Mermoud A, et al. XEN Gel Stent in Pseudoexfoliative Glaucoma: 2-Year Results of a Prospective Evaluation. J Glaucoma. 2019;28(8):676–684. doi: 10.1097/IJG.0000000000001295
   PubMed Web of Science ®Google Scholar
• Grover DS, Flynn WJ, Bashford KP, et al. Performance and safety of a New Ab Interno Gelatin Stent in refractory glaucoma at 12 months. Am J Ophthalmol. 2017;183:25–36. doi: 10.1016/j.ajo.2017.07.023
   PubMed Web of Science ®Google Scholar
• Sheybani A, Vera V, Grover DS, et al. Gel stent versus Trabeculectomy: the randomized, multicenter, gold-standard pathway study (GPS) of effectiveness and safety at 12 months. Am J Ophthalmol. 2023;252:306–325. doi: 10.1016/j.ajo.2023.03.026
   PubMed Web of Science ®Google Scholar
• Theilig T, Rehak M, Busch C, et al. Comparing the efficacy of trabeculectomy and XEN gel microstent implantation for the treatment of primary open-angle glaucoma: a retrospective monocentric comparative cohort study. Sci Rep. 2020 [Published 2020 Nov 9];10(1):19337. doi: 10.1038/s41598-020-76551-y
   PubMed Web of Science ®Google Scholar
• Wanichwecharungruang B, Ratprasatporn N, Mohan RR. 24-month outcomes of XEN45 gel implant versus trabeculectomy in primary glaucoma.PloS One. 2021 [Published 2021 Aug 19];16(8):e0256362. doi: 10.1371/journal.pone.0256362
   PubMed Web of Science ®Google Scholar
• El Helwe H, Ingram Z, Falah H, et al. Comparing outcomes of 45 μm gelatin stent placed ab externo with Open Conjunctiva to ab externo with closed Conjunctiva. Ophthalmol Glaucoma [Published online 2023 Aug 2]. doi: 10.1016/j.ogla.2023.07.009
   Google Scholar
• Schlenker MB, Gulamhusein H, Conrad-Hengerer I, et al. Efficacy, safety, and risk factors for failure of standalone ab interno gelatin microstent implantation versus standalone trabeculectomy [published correction appears in ophthalmology. 2018 Mar;125(3): 463]. Ophthalmol. 2017;124(11):1579–1588.
   PubMed Web of Science ®Google Scholar
• Evers C, Böhringer D, Kallee S. et al. XEN®-63 Compared to XEN®-45 Gel Stents to Reduce Intraocular Pressure in Glaucoma. J Clin Med. 2023 [Published 2023 Jul 31];12(15):5043. doi: 10.3390/jcm12155043
   PubMed Web of Science ®Google Scholar
• Lenzhofer M, Kersten-Gomez I, Sheybani A, et al. Four-year results of a minimally invasive transscleral glaucoma gel stent implantation in a prospective multi-centre study. Clin Exp Ophthalmol. 2019;47(5):581–587. doi: 10.1111/ceo.13463
   PubMed Web of Science ®Google Scholar
• Pelitli Gürlü V, Güçlü H, Özal A, et al. Comparison of long-term results of trabeculectomy to treat pseudoexfoliative glaucoma and primary open angle glaucoma.Int J Ophthalmol. 2018 [Published 2018 Jan 18];11(1):66–70. doi: 10.18240/ijo.2018.01.12
   PubMed Web of Science ®Google Scholar
• Riva I, Micheletti E, Oddone F. et al. Anterior Chamber Angle Assessment Techniques: A Review. J Clin Med. 2020 [Published 2020 Nov 25];9(12):3814. doi: 10.3390/jcm9123814
   PubMed Web of Science ®Google Scholar
• Qian Z, Xie X, Yang J, et al. Detection of shallow anterior chamber depth from two-dimensional anterior segment photographs using deep learning. BMC Ophthalmol. 2021 [Published 2021 Sep 22];21(1):341. doi: 10.1186/s12886-021-02104-0
   PubMed Web of Science ®Google Scholar
• Chihara E, Chihara T. Ocular hypotension and Epiretinal Membrane as risk factors for visual deterioration following glaucoma filtering surgery. J Glaucoma. 2021;30(6):515–525. doi: 10.1097/IJG.0000000000001832
   PubMed Web of Science ®Google Scholar
• Gass JDM. Hypotony maculopathy. In: Bellows J, editor. Contemporary ophthalmology, honoring sir Steward Duke-Elder. Baltimore: Williams and Wilkins; 1972. p. 343–366.
   Google Scholar
• Sakamoto M, Matsumoto Y, Mori S, et al. Excessive scleral shrinkage, rather than choroidal thickening, is a major contributor to the development of hypotony maculopathy after trabeculectomy. PloS One. 2018 [Published 2018 Jan 26];13(1):e0191862. doi: 10.1371/journal.pone.0191862
   PubMed Web of Science ®Google Scholar
• Costa VP, Arcieri ES. Hypotony maculopathy. Acta Ophthalmol Scand. 2007;85(6):586–597. doi: 10.1111/j.1600-0420.2007.00910.x
   PubMedGoogle Scholar
• Sacchi M, Fea AM, Monsellato G. et al. Safety and efficacy of ab interno XEN 45 gel stent in patients with glaucoma and high myopia. J Clin Med. 2023 [Published 2023 Mar 24];12(7):2477. doi: 10.3390/jcm12072477
   PubMed Web of Science ®Google Scholar
• Fea A, Sacchi M, Franco F, et al. Effectiveness and safety of XEN45 in eyes with high myopia and Open Angle Glaucoma. J Glaucoma. 2023;32(3):178–185. doi: 10.1097/IJG.0000000000002151
   PubMed Web of Science ®Google Scholar
• Huth A, Viestenz A. Hohe Myopie bei vitrektomiertem Auge : Kontraindikation für minimal-invasive glaukomchirurgische Implantate? [High myopia in vitrectomized eyes : Contraindication for minimally invasive glaucoma surgery implant?]. Ophthalmologe. 2020;117(5):461–466. doi: 10.1007/s00347-019-00950-4
   PubMedGoogle Scholar
• Birnbaum FA, Mirzania D, Swaminathan SS, et al. Risk factors for corneal striae in eyes after glaucoma surgery. J Glaucoma. 2022;31(2):116–122. doi: 10.1097/IJG.0000000000001888
   PubMed Web of Science ®Google Scholar
• Abualhasan H, Mimouni M, Safuri S, et al. Anterior corneal folds correlate with low intraocular pressure and May serve as a Marker for ocular hypotony. J Glaucoma. 2019;28(2):178–180. doi: 10.1097/IJG.0000000000001166
   PubMed Web of Science ®Google Scholar
• Schrieber C, Liu Y. Choroidal effusions after glaucoma surgery. Curr Opin Ophthalmol. 2015;26(2):134–142. doi: 10.1097/ICU.0000000000000131
   PubMed Web of Science ®Google Scholar
• Waheed NK, Mendonça LSM, Young LH. Choroidal effusions and detachments. Albert Jakobiecs Princ Pract Ophthalmol. 2020. doi: 10.1007/978-3-319-90495-5_125-1
   Google Scholar
• Cutolo CA, Negri L, Olivari S, et al. Choroidal Detachment after XEN Gel Stent Implantation. J Ophthalmol. 2021 [Published 2021 Mar 6];2021:6674505. doi: 10.1155/2021/6674505
   PubMed Web of Science ®Google Scholar
• Geyer O, Neudorfer M, Lazar M. Recurrent choroidal detachment following timolol therapy in previously filtered eye. Choroidal detachment post filtering surgery. Acta Ophthalmol (Copenh). 1992;70(5):702–703. doi: 10.1111/j.1755-3768.1992.tb02157.x
   PubMed Web of Science ®Google Scholar
• Vela MA, Campbell DG. Hypotony and ciliochoroidal detachment following pharmacologic aqueous suppressant therapy in previously filtered patients. Ophthalmol. 1985;92(1):50–57. doi: 10.1016/s0161-6420(85)34060-5
   PubMed Web of Science ®Google Scholar
• Alimgil ML, Benian O. Choroidal effusion and shallowing of the anterior chamber after adjunctive therapy with latanoprost in a trabeculectomized patient with angle closure glaucoma. Int Ophthalmol. 2001;24(3):129–131. doi: 10.1023/a:1021138327674
   PubMedGoogle Scholar
• Marques Pereira ML, Katz LJ. Choroidal detachment after the use of topical latanoprost. Am J Ophthalmol. 2001;132(6):928–929. doi: 10.1016/s0002-9394(01)01143-6
   PubMed Web of Science ®Google Scholar
• Callahan C, Ayyala RS. Hypotony and choroidal effusion induced by topical timolol and dorzolamide in patients with previous glaucoma drainage device implantation. Ophthalmic Surg Lasers Imaging. 2003;34(6):467–469. doi: 10.3928/1542-8877-20031101-07
   PubMedGoogle Scholar
• Goldberg S, Gallily R, Bishara S, et al. Dorzolamide-induced choroidal detachment in a surgically untreated eye. Am J Ophthalmol. 2004;138(2):285–286. doi: 10.1016/j.ajo.2004.02.070
   PubMed Web of Science ®Google Scholar
• Lima VC, Prata TS, Castro DP, et al. Macular changes detected by Fourier-domain optical coherence tomography in patients with hypotony without clinical maculopathy. Acta Ophthalmol. 2011;89(3):e274–e277.
   PubMed Web of Science ®Google Scholar
• Raja M, Boukavala S, Goldsmith C. et al. Spectral domain OCT to diagnose clinically inapparent hypotony maculopathy using 3D image rendering software. BMJ Case Rep. 2012 [Published 2012 Dec 20];2012:bcr2012007842. doi: 10.1136/bcr-2012-007842
   PubMedGoogle Scholar
• Azuma K, Saito H, Takao M, et al. Frequency of hypotonic maculopathy observed by spectral domain optical coherence tomography in post glaucoma filtration surgery eyes. Am J Ophthalmol Case Rep. 2020 [Published 2020 Jun 18];19:100786. doi: 10.1016/j.ajoc.2020.100786
   PubMedGoogle Scholar
• Cutolo CA, Iester M, Bagnis A, et al. Early postoperative intraocular pressure is associated with better pressure control after XEN implantation. J Glaucoma. 2020;29(6):456–460. doi: 10.1097/IJG.0000000000001501
   PubMed Web of Science ®Google Scholar
• Fea AM, Bron AM, Economou MA, et al. European study of the efficacy of a cross-linked gel stent for the treatment of glaucoma. J Cataract Refract Surg. 2020;46(3):441–450. doi: 10.1097/j.jcrs.0000000000000065
   PubMed Web of Science ®Google Scholar
• Midha N, Rao HL, Mermoud A, et al. Identifying the predictors of needling after XEN gel implant. Eye (Lond). 2019;33(3):353–357. doi: 10.1038/s41433-018-0206-0
   PubMed Web of Science ®Google Scholar
• Jeong HJ, Park HYL, Park CK. Effects of early postoperative intraocular pressure after Ahmed Glaucoma Valve Implantation on Long-term Surgical Outcomes. Korean J Ophthalmol. 2018;32(5):391–399. doi: 10.3341/kjo.2017.0102
   PubMedGoogle Scholar
• Bruynseels A, Sii F, Masood I, et al. Severe intraocular pressure elevation after Intracameral Healon 5 viscoelastic support for postoperative hypotony after XEN gel stent insertion. J Glaucoma. 2018;27(4):e75–e76. doi: 10.1097/IJG.0000000000000883
   PubMed Web of Science ®Google Scholar
• Franco F, Serino F, Giansanti F. “Air and Visco” technique: a promising innovation in the surgical implantation of the xen gel stent device. Vision (Basel). 2023 [Published 2023 Nov 2];7(4):71. doi: 10.3390/vision7040071
   PubMedGoogle Scholar
• Vera V, Gagne S, Myers JS, et al. Surgical approaches for implanting xen gel stent without conjunctival dissection. Clin Ophthalmol. 2020;14:2361–2371. Published 2020 Aug 17. doi:10.2147/OPTH.S265695.
   PubMed Web of Science ®Google Scholar
• Duong AT, Yuan M, Koenig LR, et al. Adverse events associated with microinvasive glaucoma surgery reported to the Food and Drug Administration. Ophthalmol Glaucoma. 2021;4(4):433–435. doi: 10.1016/j.ogla.2020.12.012
   PubMedGoogle Scholar
• Hamidovic L, Khatib T, Dimitriou C, et al. XEN-related hypotonous maculopathy from iatrogenic cyclodialysis cleft treated with argon laser gonio-cyclopexy. BMJ Case Rep. 2022 [Published 2022 Mar 8];15(3):e244933. doi: 10.1136/bcr-2021-244933
   PubMedGoogle Scholar
• Karimi A, Lindfield D, Turnbull A, et al. A multi-centre interventional case series of 259 ab-interno xen gel implants for glaucoma, with and without combined cataract surgery. Eye (Lond). 2019;33(3):469–477. doi: 10.1038/s41433-018-0243-8
   PubMed Web of Science ®Google Scholar
• Zheng DP, Dai DN, Mi L, et al. Cyclopexy on cyclodialysis cleft guided by anterior segment optic coherence tomography. Zhonghua Yi Xue Za Zhi. 2018 Dec 25;98(48):3921–3924. Chinese. doi: 10.3760/cma.j.issn.0376-2491.2018.48.003
   PubMedGoogle Scholar
• Elubous KA, Saheb H. Imaging Angle Recession Using Anterior Segment OCT. Ophthalmol Glaucoma. Ophthalmol Glaucoma [Published online 2023 Nov 2]. doi: 10.1016/j.ogla.2023.10.002
   Google Scholar
• Fea AM, Menchini M, Rossi A. et al. Early experience with the New XEN63 Implant in primary open-angle glaucoma patients: clinical outcomes. J Clin Med. 2021 [Published 2021 Apr 12];10(8):1628. doi: 10.3390/jcm10081628
   PubMed Web of Science ®Google Scholar
• Panarelli JF, Yan DB, Francis B, et al. XEN Gel Stent Open Conjunctiva Technique: A Practical Approach Paper. Adv Ther. 2020;37(5):2538–2549. doi: 10.1007/s12325-020-01278-1
   PubMed Web of Science ®Google Scholar
• Wolters JEJ, van Mechelen RJS, Al Majidi R, et al. History, presence, and future of mitomycin C in glaucoma filtration surgery. Curr Opin Ophthalmol. 2021;32(2):148–159. doi: 10.1097/ICU.0000000000000729
   PubMed Web of Science ®Google Scholar
• Mietz H, Addicks K, Diestelhorst M, et al. Extraocular application of mitomycin C in a rabbit model: cytotoxic effects on the ciliary body and epithelium. Ophthalmic Surg Lasers Imaging. 1994;25(4):240–244. doi: 10.3928/1542-8877-19940401-09
   Google Scholar
• Mietz H. The toxicology of mitomycin C on the ciliary body. Curr Opin Ophthalmol. 1996;7(2):72–79. doi: 10.1097/00055735-199604000-00013
   PubMedGoogle Scholar
• De Gregorio A, Pedrotti E, Stevan G, et al. XEN glaucoma treatment system in the management of refractory glaucomas: a short review on trial data and potential role in clinical practice. Clin Ophthalmol. 2018 [Published 2018 Apr 30];12:773–782.
   PubMed Web of Science ®Google Scholar
• Monja-Alarcón N, Perucho-Martínez S, Buenasmañanas-Maeso M, et al. Does mitomycin-C concentration have any influence on XEN45 gel stent outcomes in a real-world setting? Graefes Arch Clin Exp Ophthalmol. 2022;260(8):2649–2661. doi: 10.1007/s00417-022-05603-y
   PubMed Web of Science ®Google Scholar
• Tannenbaum DP, Hoffman D, Greaney MJ, et al. Outcomes of bleb excision and conjunctival advancement for leaking or hypotonous eyes after glaucoma filtering surgery. Br J Ophthalmol. 2004;88(1):99–103. doi: 10.1136/bjo.88.1.99
   PubMed Web of Science ®Google Scholar
• Gagné S, Yuen D, Cohen S. Transconjunctival XEN45 Implantation for Glaucoma Performed at the Slit Lamp: A Pilot Study. J Glaucoma. 2022;31(8):675–681. doi: 10.1097/IJG.0000000000002070
   PubMed Web of Science ®Google Scholar
• Buffault J, Baudouin C, Labbé A. L’implant XEN® pour la prise en charge du glaucome chronique à angle ouvert : une revue de la littérature [XEN® Gel Stent for management of chronic open angle glaucoma: A review of the literature (French translation of the article)]. J Fr Ophtalmol. 2019;42(4):391–403. doi: 10.1016/j.jfo.2018.10.005
   PubMed Web of Science ®Google Scholar