山东大学耳鼻喉眼学报 ›› 2023, Vol. 37 ›› Issue (1): 145-151.doi: 10.6040/j.issn.1673-3770.0.2021.468

• 综述 • 上一篇    

XEN微支架在青光眼手术中的应用进展

钟煜1, 廖智敏1,段宣初2   

  1. 1. 中南大学爱尔眼科学院/长沙爱尔眼科医院/武汉大学附属爱尔眼科医院 眼科, 湖北 武汉 430061;
    2. 中南大学爱尔眼科学院/长沙爱尔眼科医院 眼科, 湖南 长沙 410015
  • 发布日期:2023-02-06
  • 通讯作者: 段宣初. E-mail:duanxchu@126.com
  • 基金资助:
    国家自然科学基金(81670859,81970801);湖南省自然科学基金(2019JJ40001);长沙市科技局重点研发项目(kh1801229);湖南省重点领域研发计划资助项目(2020SK2133);爱尔眼科医院集团科研基金(AR1906D1,AM1906D2)

Progress in the applications of XEN microstent in glaucoma surgery

ZHONG Yu1, LIAO Zhimin1, DUAN Xuanchu2   

  1. 1. Department of Ophthalmology, Aier School of Ophthalmology, Central South University/ Changsha Aier Eye Hospital/ Aier Eye Hospital of Wuhan University, Wuhan 430061, Hubei, China;
    2. Department of Ophthalmology, Aier School of Ophthalmology, Central South University/ Changsha Aier Eye Hospital, Changsha 410015, Hunan, China
  • Published:2023-02-06

摘要: 青光眼的治疗主要是降低眼压,将眼压控制在不使视神经损害进一步发展的水平。传统抗青光眼手术治疗存在降压效果不稳定、降压时间有限且并发症发生率较高等局限性,这就促成了新型微创青光眼手术方式的出现,如XEN微支架植入术,这一新技术的有效性及安全性在许多临床研究中得以证实,同时也获得了越来越多的关注。为使更多的眼科医生了解XEN微支架植入术,论文通过分析整理近年来与XEN微支架植入术相关的文献并加以概括总结,探讨XEN微支架植入术在青光眼手术中的应用与研究进展。

关键词: 青光眼, XEN微支架, 微创青光眼手术

Abstract: The major target of glaucoma treatment is lowing intraocular pressure, to prevent further optic nerve damage. The limit of traditional procedures, like the unstable postoperative intraocular pressure and postoperative complications, has contributed to the emergence of a new type of minimally anvasive glaucoma surgery, such as the XEN microstent implantation. The effectiveness and safety of this new technology have been confirmed in many clinical studies and have thus been gaining more attention. To enable ophthalmologists to better understand XEN microstent implantation in glaucoma surgery, this paper summarizes the applications and research progress of XEN microstent implantation in glaucoma surgery by analyzing and summarizing the related literatures on XEN microstent implantation in recent years.

Key words: Glaucoma, XEN microstents, Minimally invasive glaucoma surgery

中图分类号: 

  • R775
[1] Chaudhary A, Salinas L, Guidotti J, et al. XEN Gel Implant: a new surgical approach in glaucoma[J]. Expert Rev Med Devices, 2018, 15(1): 47-59. doi:10.1080/17434440.2018.1419060
[2] Fea AM, Durr GM, Marolo P, et al. XEN® gel stent: a comprehensive review o2 its use as a treatment option for refractory glaucoma[J]. Clin Ophthalmol, 2020, 14: 1805-1832. doi:10.2147/OPTH.S178348
[3] Lewis RA. Ab interno approach to the subconjunctival space using a collagen glaucoma stent[J]. J Cataract Refract Surg, 2014, 40(8): 1301-1306. doi:10.1016/j.jcrs.2014.01.032
[4] Kerr NM, Wang J, Barton K. Minimally invasive glaucoma surgery as primary stand-alone surgery for glaucoma[J]. Clin Exp Ophthalmol, 2017, 45(4): 393-400. doi:10.1111/ceo.12888
[5] Sheybani A, Lenzhofer M, Hohensinn M, et al. Phacoemulsification combined with a new ab interno gel stent to treat open-angle glaucoma: pilot study[J]. J Cataract Refract Surg, 2015, 41(9): 1905-1909. doi:10.1016/j.jcrs.2015.01.019
[6] Sheybani A, Reitsamer H, Ahmed II. Fluid dynamics of a novel micro-fistula implant for the surgical treatment of glaucoma[J]. Invest Ophthalmol Vis Sci, 2015, 56(8): 4789-4795. doi:10.1167/iovs.15-16625
[7] Lavin-Dapena C, Cordero-Ros R, D'Anna O, et al. XEN 63 gel stent device in glaucoma surgery: a 5-years follow-up prospective study[J]. Eur J Ophthalmol, 2021, 31(4): 1829-1835. doi:10.1177/1120672120952033
[8] Sheybani A, Dick HB, Ahmed II. Early clinical results of a novel ab interno gel stent for the surgical treatment of open-angle glaucoma[J]. J Glaucoma, 2016, 25(7): e691-e696. doi:10.1097/IJG.0000000000000352
[9] Reitsamer H, Sng C, Vera V, et al. Two-year results of a multicenter study of the ab interno gelatin implant in medically uncontrolled primary open-angle glaucoma[J]. Albrecht Von Graefes Arch Fur Klinische Und Exp Ophthalmol, 2019, 257(5): 983-996. doi:10.1007/s00417-019-04251-z
[10] Ucar F, Cetinkaya S. Xen implantation in patients with primary open-angle glaucoma: comparison of two different techniques[J]. Int Ophthalmol, 2020, 40(10): 2487-2494. doi:10.1007/s10792-020-01427-z
[11] Kalina AG, Kalina PH, Brown MM. XEN® gel stent in medically refractory open-angle glaucoma: results and observations after one year of use in the United States[J]. Ophthalmol Ther, 2019, 8(3): 435-446. doi:10.1007/s40123-019-0192-8
[12] Mansouri K, Bravetti GE, Gillmann K, et al. Two-year outcomes of XEN gel stent surgery in patients with open-angle glaucoma[J]. Ophthalmol Glaucoma, 2019, 2(5): 309-318. doi:10.1016/j.ogla.2019.03.011
[13] Marcos Parra MT, Salinas López JA, López Grau NS, et al. XEN implant device versus trabeculectomy, either alone or in combination with phacoemulsification, in open-angle glaucoma patients[J]. Albrecht Von Graefes Arch Fur Klinische Und Exp Ophthalmol, 2019, 257(8): 1741-1750. doi:10.1007/s00417-019-04341-y
[14] Fernández-García A, Zhou Y, García-Alonso M, et al. Medium-term clinical outcomes following Xen45 device implantation[J]. Int Ophthalmol, 2020, 40(3): 709-715. doi:10.1007/s10792-019-01232-3
[15] Olgun A, Aktas Z, Ucgul AY. XEN gel implant versus gonioscopy-assisted transluminal trabeculotomy for the treatment of open-angle glaucoma[J]. Int Ophthalmol, 2020, 40(5): 1085-1093. doi:10.1007/s10792-019-01271-w
[16] Ibáñez-Muñoz A, Soto-Biforcos VS, Chacón-González M, et al. One-year follow-up of the XEN® implant with mitomycin-C in pseudoexfoliative glaucoma patients[J]. Eur J Ophthalmol, 2019, 29(3): 309-314. doi:10.1177/1120672118795063
[17] Mansouri K, Gillmann K, Rao HL, et al. Prospective evaluation of XEN gel implant in eyes with pseudoexfoliative glaucoma[J]. J Glaucoma, 2018, 27(10): 869-873. doi:10.1097/IJG.0000000000001045
[18] Gillmann K, Bravetti GE, Mermoud A, et al. XEN gel stent in pseudoexfoliative glaucoma: 2-year results of a prospective evaluation[J]. J Glaucoma, 2019, 28(8): 676-684. doi:10.1097/IJG.0000000000001295
[19] Hohberger B, Welge-Lüβen UC, Lämmer R. MIGS: therapeutic success of combined Xen Gel Stent implantation with cataract surgery[J]. Albrecht Von Graefes Arch Fur Klinische Und Exp Ophthalmol, 2018, 256(3): 621-625. doi:10.1007/s00417-017-3895-3
[20] Ba??塂er EF, Seymenoglu RG. Results of fluorouracil-augmented Xen45 implantation in primary open-angle and pseudoexfoliation glaucoma[J]. Int Ophthalmol, 2021, 41(3): 945-955. doi:10.1007/s10792-020-01650-8
[21] Klug E, Solá-Del Valle D. Bilateral XEN gel stent implantation in juvenile-onset open-angle glaucoma[J]. Case Rep Ophthalmol, 2020, 11(2): 336-341. doi:10.1159/000508391
[22] Schlenker MB, Gulamhusein H, Conrad-Hengerer I, et al. Efficacy, safety, and risk factors for failure of standalone ab interno gelatin microstent implantation versus standalone trabeculectomy[J]. Ophthalmology, 2017, 124(11): 1579-1588. doi:10.1016/j.ophtha.2017.05.004
[23] Widder RA, Dietlein TS, Dinslage S, et al. The XEN45 Gel Stent as a minimally invasive procedure in glaucoma surgery: success rates, risk profile, and rates of re-surgery after 261 surgeries[J]. Albrecht Von Graefes Arch Fur Klinische Und Exp Ophthalmol, 2018, 256(4): 765-771. doi:10.1007/s00417-018-3899-7
[24] Morgan WH, Yu DY. XEN-45 gelatin microfistula for uveitic glaucoma[J]. Clin Exp Ophthalmol, 2018, 46(4): 323-324. doi:10.1111/ceo.13307
[25] Sng CC, Wang J, Hau S, et al. XEN-45 collagen implant for the treatment of uveitic glaucoma[J]. Clin Exp Ophthalmol, 2018, 46(4): 339-345. doi:10.1111/ceo.13087
[26] Yu JTS, Au L. Conjunctival bleb compression as a treatment for hypotony post XEN45 implant in uveitic glaucoma[J]. Eur J Ophthalmol, 2020, 30(1): 217-220. doi:10.1177/1120672119836339
[27] Widder RA, Lappas A, Rennings C, et al. Primary versus posttrabeculectomy XEN45 gel stent implantation: comparison of success rates and intraocular pressure-lowering potential in pseudophakic eyes[J]. J Glaucoma, 2020, 29(12): 1115-1119. doi:10.1097/IJG.0000000000001649
[28] Lindland A, Edward Michelet JT, Slagsvold JE. Use of the XEN gel implant in a patient with aniridia-associated glaucoma[J]. Am J Ophthalmol Case Rep, 2021, 22: 101080. doi:10.1016/j.ajoc.2021.101080
[29] De Gregorio A, Pedrotti E, Stevan G, et al. XEN glaucoma treatment system in the management of refractory glaucomas: a short review on trial data and potential role in clinical practice[J]. Clin Ophthalmol, 2018, 12: 773-782. doi:10.2147/OPTH.S146919
[30] Ozal SA, Kaplaner O, Basar BB, et al. An innovation in glaucoma surgery: XEN45 gel stent implantation[J]. Arq Bras Oftalmol, 2017, 80(6): 382-385. doi:10.5935/0004-2749.20170093
[31] Galal A, Bilgic A, EltanamLy R, et al. XEN glaucoma implant with mitomycin C1-year follow-up: result and complications[J]. J Ophthalmol, 2017, 2017: 5457246. doi:10.1155/2017/5457246
[32] de Gregorio A, Pedrotti E, Russo L, et al. Minimally invasive combined glaucoma and cataract surgery: clinical results of the smallest ab interno gel stent[J]. Int Ophthalmol, 2018, 38(3): 1129-1134. doi:10.1007/s10792-017-0571-x
[33] Mansouri K, Guidotti J, Rao HL, et al. Prospective evaluation of standalone XEN gel implant and combined phacoemulsification-XEN gel implant surgery: 1-year results[J]. J Glaucoma, 2018, 27(2): 140-147. doi:10.1097/IJG.0000000000000858
[34] Poelman HJ, Pals J, Rostamzad P, et al. Efficacy of the XEN-implant in glaucoma and a meta-analysis of the literature[J]. J Clin Med, 2021, 10(5): 1118. doi:10.3390/jcm10051118
[35] Roberts DK, Newman TL, Roberts MF, et al. Long anterior lens zonules and intraocular pressure[J]. Invest Ophthalmol Vis Sci, 2018, 59(5): 2015-2023. doi:10.1167/iovs.17-23705
[36] Tan NE, Tracer N, Terraciano A, et al. Comparison of safety and efficacy between ab interno and ab externo approaches to XEN gel stent placement[J]. Clin Ophthalmol, 2021, 15: 299-305. doi:10.2147/OPTH.S292007
[37] Bell K, de Padua Soares Bezerra B, Mofokeng M, et al. Learning from the past: Mitomycin C use in trabeculectomy and its application in bleb-forming minimally invasive glaucoma surgery[J]. Surv Ophthalmol, 2021, 66(1): 109-123. doi:10.1016/j.survophthal.2020.05.005
[38] Karimi A, Lindfield D, Turnbull A, et al. A multi-centre interventional case series of 259 ab-interno Xen gel implants for glaucoma, with and without combined cataract surgery[J]. Eye(Lond), 2019, 33(3): 469-477. doi:10.1038/s41433-018-0243-8
[39] Smith M, Charles R, Abdel-Hay A, et al. 1-year outcomes of the Xen45 glaucoma implant[J]. Eye(Lond), 2019, 33(5): 761-766. doi:10.1038/s41433-018-0310-1
[40] Tan SZ, Walkden A, Au L. One-year result of XEN45 implant for glaucoma: efficacy, safety, and postoperative management[J]. Eye(Lond), 2018, 32(2): 324-332. doi:10.1038/eye.2017.162
[41] Heidinger A, Schwab C, Lindner E, et al. A retrospective study of 199 Xen45 stent implantations from 2014 to 2016[J]. J Glaucoma, 2019, 28(1): 75-79. doi:10.1097/IJG.0000000000001122
[42] Gabbay IE, Allen F, Morley C, et al. Efficacy and safety data for the XEN45 implant at 2 years: a retrospective analysis[J]. Br J Ophthalmol, 2020, 104(8): 1125-1130. doi:10.1136/bjophthalmol-2019-313870
[43] Gillmann K, Mansouri K. Minimally invasive glaucoma surgery: where is the evidence? [J]. Asia Pac J Ophthalmol(Phila), 2020, 9(3): 203-214. doi:10.1097/APO.0000000000000294
[44] Laroche D, Nkrumah G, Ng C. Real-world retrospective consecutive study of ab interno XEN 45 gel stent implant with mitomycin C in black and Afro-Latino patients with glaucoma: 40% required secondary glaucoma surgery at 1 year[J]. Middle East Afr J Ophthalmol, 2020, 26(4): 229-234. doi:10.4103/meajo.MEAJO_126_19
[45] Eraslan M, Özcan AA, Dericioglu V, et al. Multicenter case series of standalone XEN implant vs. combination with phacoemulsification in Turkish patients[J]. Int Ophthalmol, 2021, 41(10): 3371-3379. doi:10.1007/s10792-021-01899-7
[46] Broadway DC, Chang LP. Trabeculectomy, risk factors for failure and the preoperative state of the conjunctiva[J]. J Glaucoma, 2001, 10(3): 237-249. doi:10.1097/00061198-200106000-00017
[47] Oddone F, Roberti G, Posarelli C, et al. Endothelial cell density after XEN implant surgery: short-term data from the Italian XEN glaucoma treatment registry(XEN-GTR)[J]. J Glaucoma, 2021, 30(7): 559-565. doi:10.1097/IJG.0000000000001840
[48] Lenzhofer M, Kersten-Gomez I, Sheybani A, et al. Four-year results of a minimally invasive transscleral glaucoma gel stent implantation in a prospective multi-centre study[J]. Clin Exp Ophthalmol, 2019, 47(5): 581-587. doi:10.1111/ceo.13463
[49] Kerr NM, Lim S, Simos M, et al. Primary needling of the ab interno gelatin microstent reduces postoperative needling and follow-up requirements[J]. Ophthalmol Glaucoma, 2021, 4(6): 581-588. doi:10.1016/j.ogla.2021.02.004
[50] Widder RA, Rennings C, Rössler GF. Open conjunctival revision after XEN45 gel stent implantation as a standardized procedure: a step by step guide. Video article[J]. Ophthalmologe, 2020, 117(8): 806-810. doi:10.1007/s00347-020-01127-0
[51] Seo JH, Lim SH. Recanalization of XEN-45 gel stent occlusion with cortical material after phaco-XEN surgery using Nd: YAG laser treatment: a case report[J]. Medicine(Baltimore), 2021, 100(34): e27010. doi:10.1097/MD.0000000000027010
[52] Ventura-Abreu N, Dotti-Boada M, Muniesa-Royo MJ, et al. XEN45 real-life evaluation: survival analysis with bleb needling and major revision outcomes[J]. Eur J Ophthalmol, 2021: 11206721211012847. doi:10.1177/11206721211012847
[53] Luebke J, Boehringer D, Anton A, et al. Trends in surgical glaucoma treatment in Germany between 2006 and 2018[J]. Clin Epidemiol, 2021, 13: 581-592. doi:10.2147/CLEP.S310542
[1] 石博影,梁皓,李一洪,唐东永. Blau综合征成年患者抗青光眼手术后并发白内障手术治疗1例并文献复习[J]. 山东大学耳鼻喉眼学报, 2022, 36(6): 60-65.
[2] 刘乐乐,孔香云综述申家泉审校. 睫状体分泌功能减弱性手术在青光眼治疗中的进展[J]. 山东大学耳鼻喉眼学报, 2022, 36(6): 123-128.
[3] 唐翡然,孔香云申家泉. 相干光层析血管成像术测量视盘旁浅层血管密度在青光眼诊疗中的作用研究进展[J]. 山东大学耳鼻喉眼学报, 2022, 36(5): 77-82.
[4] 赵颖,张珊许家骏,赵静如. 热休克蛋白72在青光眼视网膜神经节细胞中的保护机制研究进展[J]. 山东大学耳鼻喉眼学报, 2022, 36(5): 83-87.
[5] 李萱, 黄映湘. 25例虹膜新生血管发生原因探讨[J]. 山东大学耳鼻喉眼学报, 2020, 34(4): 41-47.
[6] 秦书琪,王露萍,姜彬,王艳玲. 眼缺血综合征并发新生血管性青光眼一例并文献复习[J]. 山东大学耳鼻喉眼学报, 2020, 34(4): 53-55.
[7] 刘瑞宝,赵颖,郭明璐,段钰,吴艳霞,路雪婧. 自噬及其在青光眼中的研究进展[J]. 山东大学耳鼻喉眼学报, 2019, 33(5): 158-161.
[8] 刘琳,郑华,谌绍林,段宣初. 干细胞移植对大鼠青光眼模型视神经保护作用及安全性的Meta分析[J]. 山东大学耳鼻喉眼学报, 2019, 33(4): 138-144.
[9] 滕兴波,曹智,孙海霞,刘宪金,杨伟舟,朱艳,朱玉广. GRP94、EIF2α在原发型闭角性青光眼小梁中的作用研究[J]. 山东大学耳鼻喉眼学报, 2019, 33(2): 115-118.
[10] 谢洪彬,杨美娜,陈青山,刘旭阳,樊宁. IgG4相关性眼病伴继发性青光眼病例分析[J]. 山东大学耳鼻喉眼学报, 2018, 32(2): 99-102.
[11] 高雪,郝琳琳,刘少华,张晗. 两种人工晶体计算公式预测闭角型青光眼合并白内障患者超声乳化手术后屈光度准确性的比较[J]. 山东大学耳鼻喉眼学报, 2018, 32(1): 68-71.
[12] 赵栋栋, 王艺, 高建鲁. 原发性开角型青光眼易感基因研究进展[J]. 山东大学耳鼻喉眼学报, 2017, 31(6): 92-96.
[13] 许晓. Ex-PRESS引流器植入术治疗青光眼的临床观察[J]. 山东大学耳鼻喉眼学报, 2017, 31(4): 90-93.
[14] 王越,柯敏,韩芳芳,王文欢,翁鸿. EX-PRESS引流器植入术与小梁切除术治疗开角型青光眼有效性和安全性的Meta分析[J]. 山东大学耳鼻喉眼学报, 2017, 31(2): 104-111.
[15] 童尧,郑岩,周雅丽,王艺晓,赵培泉,汪朝阳. 各型青光眼患者眼内TNF-α及IP-10水平及其相关性分析[J]. 山东大学耳鼻喉眼学报, 2017, 31(1): 103-106.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!