Evidence map›Paper›PMID 39215237›Full record

ArticleBMC ophthalmology2024

Ab-Externo XEN Gel stent implantation effectively treated refractory glaucoma with prior failed shunt tube.

Anny M S Cheng, Shailesh K Gupta, Geetha G Vedula, Jackson Saddemi, Victor Wang, Rita Vartanian, David T Y Yang, Aarup A Kubal

Abstract read
In one paragraph

Article in BMC ophthalmology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Anny M S ChengDepartment of Ophthalmology, Broward Health, Fort Lauderdale, FL, USA.
Shailesh K GuptaDepartment of Ophthalmology, Broward Health, Fort Lauderdale, FL, USA.
Geetha G VedulaDepartment of Ophthalmology, Broward Health, Fort Lauderdale, FL, USA.
Jackson SaddemiDepartment of Ophthalmology, Broward Health, Fort Lauderdale, FL, USA.
Victor WangBurnett School of Biomedical Sciences, University of Central Florida, Orlando, FL, USA.
Rita VartanianSpecialty Retina Center, Deerfield Beach, FL, USA.
David T Y YangSpecialty Retina Center, Deerfield Beach, FL, USA.
Aarup A KubalDepartment of Ophthalmology, Broward Health, Fort Lauderdale, FL, USA. akubal@yeseyespecialists.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo assess the efficacy of a gelatin stent (XEN 45 Gel Stent; Allergan) implant in advanced glaucoma eyes that have failed prior aqueous shunt implantation.

methodsWe retrospectively reviewed 6 patients with refractory glaucoma, defined as persistently high IOP (> 21 mmHg) despite taking at least 3 IOP-lowering medications subsequent to undergoing a glaucoma drainage device (GDD) with or without a second GDD or cilioablative procedure. Eyes with previous failed GDD underwent subconjunctival 0.3 cc (0.4 mg/ml) mitomycin C, tenonectomy, and placement of an ab- externo XEN stent. The outcome measures included change in IOP and the number of glaucoma medications. Success was defined as patients achieving an IOP ≤ 18 mmHg with a percentage reduction of 25% or 15 mmHg and 40% mean IOP reduction from baseline while taking the same number or fewer medications.

resultsAll six eyes with age of 77.6 ± 7.82 years who underwent XEN implantation following previous GDD surgery had primary open-angle glaucoma. The IOP decreased significantly from 32.33 ± 5.99 to 12.67 ± 3.27 mmHg (p < 0.001) with a follow-up of 13.9 ± 2 (11.7-16.7) months. Visual acuity and visual field remained stable after XEN placement. Compared to the baseline number of medications of 4.2 ± 0.8, all medication was discontinued except in one eye on two drops at the end of the follow-up. The overall surgical success rate was 100%. No complications, needling, or additional procedures were required.

conclusionThis study described successful implantation of the XEN stent following failed GDD. XEN Gel stent implantation associated with mitomycin C and tenonectomy can be considered a viable surgical option for patients with a history of previously failed tube shunt requiring further IOP lowering.

Indexed as

Glaucoma Drainage ImplantsIntraocular PressureStentsVisual AcuityAgedAged, 80 and overFemaleFollow-Up StudiesGelatinGlaucomaGlaucoma, Open-AngleHumansMaleMiddle AgedProsthesis ImplantationRetrospective StudiesGelatinGlaucoma drainage deviceMinimally invasive Glaucoma surgeriesShunt tubeTenonectomyXEN Gel Stent

Identifiers

PMID39215237
PMCPMC11365280

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.