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Xen45 gel stent may be useful in managing patients with primary angle closure glaucoma

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BALTIMORE — In patients with primary angle closure glaucoma, the Xen45 gel stent may be a useful option because of its small size, soft polymer composition and anterior chamber placement, according to a presentation here.

“We were able to see that the IOP reduction and safety profile are similar to what we understand in open-angle patients, so we think this warrants some further investigation in angle closure patients,” Susan S. Lee, PhD, said in an interview with Healio.com/OSN at the Association for Research in Vision and Ophthalmology annual meeting.

Fifteen eyes of 13 patients with PACG were implanted with the Xen gel stent (Allergan). One case was a solo procedure while the rest were implanted immediately after cataract extraction.

Mean preoperative medicated IOP was 19.5 ± 2.9 mm Hg, which decreased to 10.8 ± 6.1 mm Hg at 1 day postop and 11.2 ± 3.5 mm Hg at 1 week postop.

Eight eyes with data at 12 months had a mean IOP of 13 ± 2.6 mm Hg, with all experiencing a decrease in IOP of 20% or more at 12 months.

Mean number of medications also decreased, from 3.3 ± 1.2 preoperatively to 0.9 ± 1.1 at 12 months.

“In this study we included 14 eyes that were implanted at the same time as cataract surgery, which opens the angle at time of surgery, which is allowed per the current label in the U.S.,” Vanessa Vera, MD, fellow researcher, said.

One patient was considered an efficacy failure at month 12 and required an additional glaucoma surgical intervention.

Transient postoperative hyphema was the most common complication. Cystoid macular edema occurred in one eye after combined surgery. – by Abigail Sutton

Reference:

Millan F, et al. Evaluation of the Xen45 gel stent in patients with primary angle closure. Presented at: Association for Research in Vision and Ophthalmology annual meeting; May 7-11, 2017; Baltimore.

Disclosure: Lee reports she is an employee of Allergan. Please see the study for all other authors’ relevant financial disclosures.