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Abstract #106049 Published in IGR 23-3
Two Year Functional and Structural Changes-A Comparison between Trabeculectomy and XEN Microstent Implantation Using Spectral Domain Optical Coherence Tomography
Bormann C; Busch C; Rehak M; Schmidt M; Scharenberg C; Scharenberg C; Ziemssen F; Unterlauft JDJournal of clinical medicine 2022; 11:
The aim of this study was to analyze retinal nerve fiber layer (RNFL) thickness after trabeculectomy (TE) versus XEN microstent implantation (XEN) in primary open-angle glaucoma (POAG) cases naïve to prior incisional glaucoma surgery. We examined 119 consecutive glaucoma patients retrospectively, who received a TE or XEN for medically uncontrolled POAG. Intraocular pressure (IOP), amount of IOP-lowering medication, mean deviation of standard automated perimetry and peripapillary RNFL thickness were evaluated during the first 24 months after surgery. Fifty eyes were treated with TE and 69 eyes with XEN. Mean IOP decreased from 25.1 ± 0.8 to 13.3 ± 0.6 mm Hg ( < 0.01) and mean number of IOP-lowering eye drops from 3.2 ± 0.2 to 0.4 ± 0.1 ( < 0.01) 24 months after TE. In 69 eyes undergoing XEN, mean IOP dropped from 24.8 ± 0.6 to 15.0 ± 0.4 mm Hg ( < 0.01) and medication from 3.0 ± 0.1 to 0.6 ± 0.1 ( < 0.01) during the 24 months follow-up. Mean deviation of standard automated perimetry remained stable in TE (8.5 ± 0.7 to 8.1 ± 0.8 dB; = 0.54) and XEN group (11,0 ± 0.5 to 11.5 ± 0.5 dB; = 0.12) after 24 months, while mean RNFL thickness further deteriorated in the TE (-2.28 ± 0.65 µm/year) and XEN (-0.68 ± 0.34 µm/year) group. Postoperative RNFL loss develops after TE and XEN despite effective and significant lowering of IOP and amount of IOP-lowering medication. RNFL loss was more pronounced in the first year after glaucoma surgery.
Department of Ophthalmology, University of Leipzig, Liebigstrasse 10-14, 04103 Leipzig, Germany.
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