XEN Microstent Implant Improves Glaucoma Outcomes, Reduces Need for Eye Drops

The XEN microstent is a minimally invasive glaucoma surgery procedure that is approved for the treatment of primary open-angle glaucoma (POAG). A study published in BMC Ophthalmology found that the XEN microstent implant reduced intraocular pressure (IOP) and the number of drug applications needed to reduce intraocular pressure, while best corrected visual acuity (BCVA) and perimetry results remained unchanged, in patients with glaucoma.

The retrospective study compared the efficacy and safety profile of a single XEN microstent in patients with primary and secondary open angle glaucoma. Researchers queried medical records of all patients scheduled for XEN microstent implantation between January 1, 2017, and December 31, 2018, at the University Eye Hospital in Leipzig, Germany. Patients received implantation for POAG, normal-tension glaucoma (NTG), pseudoexfoliation glaucoma (PEX), and secondary glaucoma (Sec.Gl). Researchers assessed IOP, active substances of the applied IOP-lowering drugs, BCVA, and mean deviation of the perimetry at baseline and at two days, as well as at one, three, six, and 12 months post-implantation.

The study included 153 eyes: 113 eyes had POAG (74%), five had NTG (3%), 22 had PEX (14%), and 13 had Sec.Gl (9%).

Mean IOP decreased in all treatment groups during the 12 months of follow-up:

  • overall: from 23.9 mmHg (standard deviation [SD], 7.4) at baseline to 15.4 mmHg (SD, 5.1) at 12 months (P<0.01)
  • POAG: from 22.8 mmHg (SD, 6.5) to 15.1 mmHg (SD, 4.6; P<0.01)
  • NTG: from 16.6 mmHg (SD, 3.4) to 11.6 mmHg (SD, 2.2; P<0.05)
  • PEX: from 28.0 mmHg (SD, 7.9) to 17.1 mmHg (SD, 6.6 mmHg; P<0.01)
  • Gl: from 28.9 mmHg (SD, 13.9) to 15.5 mmHg (SD, 6.9; P<0.05)

Among all eyes, the average number of IOP-lowering drugs applied decreased from 2.6 (SD, 1.2) at baseline to 0.8 (SD, 1.3) 12 months after surgery (P<0.01). BCVA and mean deviation of automated standard perimetry remained stable in all groups during follow-up.

“The data presented here on the efficacy and safety of the XEN microstent in glaucoma types other than POAG are encouraging for the use of this (comparatively new) technique also in the treatment of PEX and other Sec.Gl cases,” the researchers concluded.