Xen gel stent with phaco has similar endothelial cell density loss as cataract surgery alone
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.