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    Gel stent for glaucoma patients finds 40% reduction in IOP

    Patients in study only need one medication versus preoperative average of three drugs

    Take-home message: Implantation of a gel stent for glaucoma studied in Europe led to a 40% reduction in IOP.

    Reviewed by Rohit Varma, MD

    Los Angeles—A new gel glaucoma stent (Xen45, Allergan/AqueSys) reduced IOP by 40% in a multicenter European study involving 60 eyes, said Rohit Varma, MD.

    The stent also reduced the number of medications patients required, said Dr. Varma, Grace and Emery Beardsley professor and chairman, USC Department of Ophthalmology; director, USC Eye Institute, Keck School of Medicine at the University of Southern California, Los Angeles.

    More Glaucoma news: Viscoelastic injection may improve microstent efficacy

    The new gel stent has been developed over the past 10 years. The hydrophilic cyndrical implant is about 6 mm long and is made of porcine gelatin crosslinked with glutaraldehyde. The material has other common medical uses.

    The implant is soft compared with other standard implants, Dr. Varma said.

    “When inserted in the eye, as you can see on an optical coherence tomography image, it’s soft so it follows the path of the related tissues,” he said.

    More Glaucoma: OCT provides minute details of aqueous outflow pathways, motion

    The procedure used to insert the device is ab interno and connects the anterior chamber to the subconjunctival space. Before its use, a surgeon inserts a low-dose mitomycin C (MMC) injection to reduce postoperative management issues and decrease the risk for fibrosis. The procedure appears to be more effective with the MMC injection, Dr. Varma said.

    The procedure is less invasive than other glaucoma implants, as it does not involve incising and dissecting the conjunctiva, he noted.

    Experience in Europe

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