Results of XEN45 Gel Stent Implantation in the Treatment of Primary Open-Angle Glaucoma Using 5, 10 or 20 μg Mitomycin C: A Pilot Study.

IF 1.8 4区 医学 Q3 OPHTHALMOLOGY
Journal of Ophthalmology Pub Date : 2024-10-26 eCollection Date: 2024-01-01 DOI:10.1155/2024/3895054
Felix F Reichel, Vanessa Guggenberger, Hanna Faber, Jonas Neubauer, Bogomil Voykov
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引用次数: 0

Abstract

Background: No consensus has been reached on the adequate dose of mitomycin C (MMC) in XEN45 gel stent implantation. Lower doses have the potential to reduce MMC-linked side effects. This study aimed to evaluate treatment efficacy of ab interno XEN45 gel stent in primary open-angle glaucoma (POAG) with three different MMC doses. Methods: This retrospective single-centre nonrandomised trail included 54 patients (56 eyes) who underwent XEN45 gel stent implantation for POAG with above-target intraocular pressure (IOP) under medical therapy. Eyes were grouped according to the received MMC dose: Group 1 (20 μg; n = 21), Group 2 (10 μg; n = 14) and Group 3 (5 μg; n = 21). The primary endpoint was the mean IOP change in the three MMC dose groups after 6, 12 and 24 months. Secondary endpoints included the success rate defined as lowering of baseline IOP ≥ 20% and below a cut-off IOP set at three different levels: ≤ 18, ≤ 16 and ≤ 14 mmHg (Criteriums 1, 2 and 3), the mean number of ocular hypotensive medications and the frequency of needling procedures. Results: After 24 months, the overall mean (standard error) IOP was significantly reduced from 24.7 (0.9) mmHg to 15.2 (0.7) mmHg (p < 0.0001). The average IOP change (standard error) in MMC dose groups 1, 2 and 3 was -8.6 (2) mmHg, -10.1 (2.1) mmHg and -10.4 (2.8) mmHg. Complete success (Criterium 1) was achieved in 50%, 62% and 43% of the eyes in groups 1, 2 and 3. No statistically significant difference was found within the first 24 months between the three MMC dose groups for IOP change, success rate, number of ocular hypotensive medications and the frequency of needling procedures. Conclusions: XE45 was effective in all three dose groups. As the success rate did not significantly differ between the MMC doses, these results may support the use of the lowest dose. Trial Registration: ClinicalTrials.gov identifier: 559/2016BO2.

使用 5、10 或 20 μg 丝裂霉素 C 治疗原发性开角型青光眼的 XEN45 凝胶支架植入术结果:试验性研究。
背景:关于 XEN45 凝胶支架植入术中丝裂霉素 C(MMC)的适当剂量,目前尚未达成共识。较低剂量有可能减少与 MMC 相关的副作用。本研究旨在评估 XEN45 凝胶支架植入原发性开角型青光眼(POAG)时使用三种不同剂量 MMC 的疗效。方法:这项回顾性单中心非随机追踪研究纳入了 54 名患者(56 只眼),他们在药物治疗下接受了 XEN45 凝胶支架植入术,以治疗眼压高于目标值的 POAG。根据接受的 MMC 剂量对患者进行分组:第一组(20 μg;n = 21)、第二组(10 μg;n = 14)和第三组(5 μg;n = 21)。主要终点是三个 MMC 剂量组在 6、12 和 24 个月后的平均眼压变化。次要终点包括成功率(定义为基线眼压降低≥20%且低于三个不同水平(标准 1、2 和 3):≤ 18、≤ 16 和≤ 14 mmHg)的临界眼压)、降眼压药物的平均用药次数和针刺手术的频率。结果显示24 个月后,总体平均眼压(标准误差)从 24.7 (0.9) mmHg 显著降至 15.2 (0.7) mmHg(p < 0.0001)。MMC剂量组1、2和3的平均眼压变化(标准误差)分别为-8.6(2)毫米汞柱、-10.1(2.1)毫米汞柱和-10.4(2.8)毫米汞柱。第 1、第 2 和第 3 组分别有 50%、62% 和 43% 的眼睛获得了完全成功(标准 1)。在最初的 24 个月内,三个 MMC 剂量组之间在眼压变化、成功率、降眼压药物使用次数和针刺手术频率方面没有发现明显的统计学差异。结论XE45 对所有三个剂量组都有效。由于不同剂量 MMC 的成功率没有明显差异,这些结果可能支持使用最低剂量。试验注册:ClinicalTrials.gov identifier:559/2016BO2。
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来源期刊
Journal of Ophthalmology
Journal of Ophthalmology MEDICINE, RESEARCH & EXPERIMENTAL-OPHTHALMOLOGY
CiteScore
4.30
自引率
5.30%
发文量
194
审稿时长
6-12 weeks
期刊介绍: Journal of Ophthalmology is a peer-reviewed, Open Access journal that publishes original research articles, review articles, and clinical studies related to the anatomy, physiology and diseases of the eye. Submissions should focus on new diagnostic and surgical techniques, instrument and therapy updates, as well as clinical trials and research findings.
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