Issue: January 2020
Source/Disclosures
Source:

Midha N, et al. J Glaucoma. 2020;doi:10.1097/IJG.0000000000001394.

January 03, 2020
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Needling revision beneficial after Xen implantation

Issue: January 2020
Source/Disclosures
Source:

Midha N, et al. J Glaucoma. 2020;doi:10.1097/IJG.0000000000001394.

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Patients with elevated IOP due to either a fibrotic or shallow bleb or increased vascularity after Xen gel stent implantation experienced a mean 35.9% IOP reduction from preoperative levels after undergoing a needling revision, according to a study.

“Our study shows that needling rates are significantly higher after Xen gel stent implantation than after standard filtering surgery,” study co-author Kaweh Mansouri, MD, MPH, told Healio/OSN.

Fifty-one eyes of 51 patients who underwent mitomycin C-augmented needling revision with at least 24 months of follow-up were included in the prospective, interventional study. Follow-up examinations were conducted at 1 day, 1 week, and 1, 3, 6, 12, 18 and 24 months. Researchers evaluated the magnitude of IOP reduction after needling revision at the last follow-up visit.

Seventy-eight needling procedures were performed over the 24-month follow-up period. Before Xen gel stent (Allergan) implantation, the mean preoperative IOP was 22.3 mm Hg, decreasing 36.8% at 1 day postoperatively to 14.1 mm Hg. The final measured IOP before the first needling revision averaged 23.6 mm Hg, which decreased to 12.1 mm Hg at the first appointment after needling. At the last follow-up appointment, on average 17 months after the first needling procedure, the mean IOP was 14.3 mm Hg, a 35.9% reduction from preoperative baseline and a 39.4% reduction from prerevision baseline.

“Needling revision, when performed with care, can enhance efficacy of the Xen gel stent,” Mansouri said.

No association was found between the number of needling revisions performed and baseline characteristics of the patients. – by Robert Linnehan

Disclosures: Mansouri reports he is a consultant to Santen, Sensimed and Implandata and is a shareholder with Topcon, Alcon, Allergan and Optovue. Please see the study for all other authors’ relevant financial disclosures.