Minimally invasive combined glaucoma and cataract surgery: clinical results of the smallest ab interno gel stent

PURPOSE: To verify the efficacy in intraocular pressure (IOP) reduction and safety of the smallest gel stent (XEN 45 Gel Stent) microincisional glaucoma surgery combined with microincisional cataract surgery (MICS). METHODS: Nonrandomized prospective clinical study. Forty-one eyes of 33 patients with open-angle glaucoma underwent a XEN 45 Gel Stent implantation combined with MICS. Treatment outcomes analyzed included: IOP, medication use, intra- and postoperative complications. At the end of the follow-up, we evaluated the complete success, defined as a postoperative IOP ≥ 6 and ≤17 mmHg without glaucoma medications and the qualified success defined as a postoperative IOP ≥ 6 and ≤17 mmHg, with glaucoma medications. RESULTS: The mean preoperative IOP was 22.5 ± 3.7 mmHg on 2.5 ± 0.9 medication classes. After 12 months, the mean postoperative IOP was 13.1 ± 2.4 mmHg (mean IOP reduction of 41.82%) with a mean of 0.4 ± 0.8 medication classes (P < 0.05 for IOP and medications). The complete success rate was achieved in 80.4% and a qualified success in 97.5%. There were no major intra- and postoperative complications during the first year of follow-up. CONCLUSIONS: This study demonstrated that the smaller diameter XEN 45 gel implant is statistically effective in reducing IOP and medications in glaucoma patients with a low rate of complications.