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Trabeculectomy versus Xen gel implant for the treatment of open-angle glaucoma: a 3-year retrospective analysis.
Cappelli, Francesca; Cutolo, Carlo Alberto; Olivari, Sara; Testa, Valeria; Sindaco, Daniele; Pizzorno, Chiara; Ciccione, Sara; Traaverso, Carlo Enrico; Iester, Michele.
Afiliação
  • Cappelli F; Eye Clinic, Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Genova, Liguria, Italy.
  • Cutolo CA; IRCCS Ospedale Policlinico San Martino, Genova, Italy.
  • Olivari S; Eye Clinic, Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Genova, Liguria, Italy.
  • Testa V; IRCCS Ospedale Policlinico San Martino, Genova, Italy.
  • Sindaco D; Eye Clinic, Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Genova, Liguria, Italy.
  • Pizzorno C; IRCCS Ospedale Policlinico San Martino, Genova, Italy.
  • Ciccione S; Eye Clinic, Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Genova, Liguria, Italy.
  • Traaverso CE; IRCCS Ospedale Policlinico San Martino, Genova, Italy.
  • Iester M; Eye Clinic, Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Genova, Liguria, Italy.
BMJ Open Ophthalmol ; 7(1): e000830, 2022.
Article em En | MEDLINE | ID: mdl-35047670
ABSTRACT

OBJECTIVE:

To compare the two surgical techniques in terms of efficacy, safety, and postoperative management over 36 months of follow-up.

METHODS:

This retrospective clinical cohort study compared the outcome of trabeculectomy surgery and Xen gel implant in patients having uncontrolled glaucoma. Patients were recruited using the following inclusion criteria uncontrolled intraocular pressure (IOP) on maximally tolerated medical therapy, healthy conjunctiva freely mobile in the superior sector, open-angle, glaucomatous visual field damage, full follow upfollow-up of at least 36 months. Thirty-four patients were submitted to trabeculectomy and 34 to Xen gel implant. We set the lower limit at 6mmHg mm Hg and the upper limit ≤12 mm Hg for criteria A, upper limit to ≤15 mm Hg for criteria B and upper limit ≤18 mm Hg for criteria C. Criteria for success have been characterizedcharacterised according to whether or not this has been achieved without (complete success) or with IOP -lowering medications (qualified success).

RESULTS:

For all survival curves, trabeculectomy was superior to Xen gel implant. When considering complete success, the log-rank test for criteria A was statistically significant (pp=0.006), marginally significant for criteria B (pp=0.065) and not significant for criteria C (pp=0.23). When qualified success was considered, trabeculectomy was superior to Xen gel for criteria A, B, and C (pp=0.012, pp=0.033 and pp=0.025, respectively). Higher number of post-operative flat chamber and bleb leakage was observed in the trabeculectomy group.

CONCLUSION:

Xen gel implant techniques offer a better safety profile but a lower IOP reduction compared to compared with the gold -standard technique.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Trabeculectomia / Glaucoma / Glaucoma de Ângulo Aberto Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Risk_factors_studies Limite: Humans Idioma: En Ano de publicação: 2022 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Trabeculectomia / Glaucoma / Glaucoma de Ângulo Aberto Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Risk_factors_studies Limite: Humans Idioma: En Ano de publicação: 2022 Tipo de documento: Article