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International Ophthalmology

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Open Access 01-01-2020 | Glaucoma | Original Paper

Efficacy of postoperative management with 5-fluorouracil injections after XEN Gel Stent implantation

Authors: Ewa Wałek, Joanna Przeździecka-Dołyk, Iwona Helemejko, Marta Misiuk-Hojło

Published in: International Ophthalmology | Issue 1/2020

Abstract

Purpose

To evaluate the efficacy of postoperative management with 5-fluorouracil injections after XEN Gel Stent implantation.

Methods

Prospective real-world evidence study included 39 eyes (of 36 patients) with primary open-angle glaucoma without previous glaucoma surgery and with uncontrolled intraocular pressure (IOP), glaucoma progression, or intolerance to IOP-lowering therapy. Patients underwent mitomycin C-augmented XEN implantation either as a stand-alone procedure or combined with cataract extraction. 5-Fluorouracil subconjunctival injections were a first-choice therapy for bleb failure and were administered according to predetermined criteria (analogous to pro re nata regimen in age-related macular degeneration treatment). Primary outcome was unqualified success, defined as postoperative IOP < 18 mmHg and > 20% reduction from medicated baseline without any antiglaucoma medications and no detected glaucoma progression.

Results

At median follow-up of 8 months (range 3–24 months), IOP decreased from a medicated baseline value of 23 mmHg (95% CI 21–24 mmHg) to 13 mmHg (95% CI 12–15 mmHg) and number of medications decreased from 3 (95% CI 2–3) to 0 (p < 0.0001 for both). Median number of 5-fluorouracil injections per eye was 3 (95% CI 2–3), and median time to first injection was 0.5 months (95% CI 0.25–3 months) after surgery. Thirteen eyes (33.3%) underwent ≥ 1 needling, and surgical revision was performed in three cases (7.7%). The primary outcome measure, which allows performing additional procedures, was achieved in 27 eyes (69%).

Conclusions

5-Fluorouracil subconjunctival injections are safe and effective in postoperative management of bleb failure after XEN implantation and represent a viable alternative to other methods.

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Title: Efficacy of postoperative management with 5-fluorouracil injections after XEN Gel Stent implantation
Authors: Ewa Wałek
Joanna Przeździecka-Dołyk
Iwona Helemejko
Marta Misiuk-Hojło
Publication date: 01-01-2020
Publisher: Springer Netherlands
Keyword: Glaucoma
Published in: International Ophthalmology / Issue 1/2020
Print ISSN: 0165-5701
Electronic ISSN: 1573-2630
DOI: https://doi.org/10.1007/s10792-019-01168-8

At a glance: The STEP trials

Springer Medicine

Efficacy of postoperative management with 5-fluorouracil injections after XEN Gel Stent implantation

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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