Patients who underwent Xen gel stent implantation combined with phacoemulsification to treat primary or secondary open-angle glaucoma experienced a similar central endothelial cell density loss at 2 years as those who underwent stand-alone phacoemulsification, according to a study.
“After 2 years, Xen gel stent does not seem to cause an additional ECD loss than cataract surgery alone,” study co-author Kaweh Mansouri, MD, told Healio/OSN.
The retrospective study included 32 eyes of 23 patients. Fifteen eyes underwent stand-alone phaco, and 17 eyes underwent phaco combined with Xen gel stent (Allergan) implantation. The mean baseline endothelial cell density (ECD) was 2,568 cells/mm2 in the stand-alone cohort and 2,379 cells/mm2 in the combination cohort.
At 2 years after surgery, the overall mean loss of ECD in the total cohort was 354.4 cells/mm2, a 14.4% statistically significant reduction from baseline (P = .004). In the stand-alone group, ECD decreased from a mean 2,567.7 cells/mm2 at baseline to 2,196.1 cells/mm2 at 2 years, a 14.5% reduction, but the difference was not statistically significant. In the combination group, mean ECD decreased from 2,378.8 cells/mm2 at baseline to 2,039.6 cells/mm2 at 2 years, a 14.3% reduction (P = .018).
The mean difference in percentage of ECD loss between the two groups was not statistically significant.
Mitomycin C-enhanced needling revision did not appear to have a statistically significant impact on ECD loss. In the combination cohort, ECD decreased by a mean of 15.4% in patients who did not undergo MMC-augmented needling revisions compared with a 13.1% decrease in those who underwent the procedure.
“Although reassuring, longer follow-up of 5 years is needed to confirm these initial findings. Remember, in the CyPass (Alcon) study, this effect only became significant after the third year,” Mansouri said. – by Robert Linnehan
Disclosures: Mansouri reports he is a consultant for Santen, Sensimed, Topcon, Alcon, Allergan, Optovue and Implandata. Please see the study for all other authors’ relevant financial disclosures.