Nasal Superior Versus Nasal Inferior Implantation of the XEN45 Gel Stent – One Year Results

Purpose: To assess effectiveness of the XEN45 gel stent after nasal superior implantation compared to nasal inferior implantation.

Methods: Retrospektive analysis of 152 eyes with XEN45 gel stent implantation in the nasal superior quadrant (Group A, n=56) or in the nasal inferior quadrant (Group B, n=96).

Results: Mean IOP decreased from 33.6± 8.8 mmHg preoperatively to 14.6± 3.2 mmHg at Month 12 in Group A (p < 0.05) and from 32.6± 10.1 mmHg to 14.1± 4.3 mmHg in Group B (p < 0.05). Medication usage reduced from 3.2± 0.9 medications at baseline to 0.3± 0.7 medications at Month 12 in Group A (p < 0.05) and from 3.1± 1.0 to 0.3± 0.7 in Group B (p < 0.05). At Month 3, a significantly lower mean IOP (p=0.023; Mann-Whitney-U-test) and medication usage (p=0.021; Welch`s t-test) were observed in Group A. At all other visits no significant differences were observed (p>0.05). Needling was required in 45% of eyes in Group A and in 27% of Group B (p=0.031; Fisher`s exact test). A second XEN45 gel stent was implanted in 4 eyes of Group A and 7 eyes of Group B. Hypotony (IOP ≤ 6 mmHg) was observed in 3 eyes of Group A and 4 eyes of Group B. All cases resolved spontanously.

Conclusion: Overall, the 1-year results of our retrospective analysis show that implantation of the XEN45 gel stents in the nasally inferior quadrant is as effective as implantation in the superior nasal quadrant and results in significantly reduced IOP and medication usage in glaucoma patients.