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KMID : 1813520230120010029
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Journal of the Korean Glaucoma Society
2023 Volume.12 No. 1 p.29 ~ p.35
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Efficacy of Bleb Needling after Ab Interno XEN Gel Stent Implantation
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Song Ji-Eun
Lee Eun-Ji
Kim Tae-Woo
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Abstract
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Purpose : To evaluate the effect of bleb needling after XEN gel stent implantation on intraocular pressure (IOP) reduction and to investigate the factors affecting surgical outcome of bleb needling in patients with open angle glaucoma.
Methods : The present study is a retrospective observational study of patients who received bleb needling after XEN gel stent implantation and were followed up for more than 12 months at Seoul National University Bundang Hospital from January 2018 to January 2022. Surgical success was defined as an IOP of 18 mmHg or less, and a decrease of 20% or more compared to the preoperative IOP. The cumulative success rate was assessed using Kaplan?Meier survival curves, and factors related to surgical failure were investigated using the Cox proportional hazards model.
Results : A total of 38 eyes were included in this study. Compared to the mean IOP before bleb needling, significant reduction in IOP was observed at postoperative 1 day, 1 week, 3, 6, and 12 months after the procedure, with values of -10.88 ± 10.45, -10.43 ± 11.66, -9.91 ± 9.17, -10.17 ± 9.04, and -8.49 ± 10.27 mmHg, respectively (all p < 0.001). In addition, lower preoperative IOP and the occurrence of postoperative IOP rise exceeding preoperative level within 1 month after XEN gel stent implantation were statistically significant risk factors for surgical failure (HR = 0.896, p = 0.028 and HR = 1.087, p = 0.013, respectively).
Conclusions : Bleb needling after XEN gel stent implantation was found to be effective in lowering IOP in patients with glaucoma. In particular, the success rate of bleb needling was higher in patients with higher preoperative IOP before XEN gel stent implantation and without postoperative IOP rise exceeding preoperative level within 1 month after XEN gel stent implantation.
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KEYWORD
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Glaucoma drainage implant, Intraocular pressure, Needling, Xen stent
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