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    Novel gelatin stent works effectively as stand-alone procedure

    Mean IOP, IOP change, medication reduction, safety studied through 12 months

    Take-home message: One-year results are reviewed for use of a novel ab-interno gelatin stent as a stand-alone procedure for patients with mild-to-moderate primary open-angle glaucoma.



    Los Angeles—New results on stand-alone implantation of a gel stent for glaucoma underscored existing data on combination glaucoma-plus-cataract surgery.

    The latest data from a multicenter European study of the gelatin stent (Xen 45) showed a mean reduction in IOP of 42% 12 months after implantation. The stent was developed by AqueSys, which was acquired by Allergan in 2015, and is widely available outside the United States. It remains an investigational device in the United States

    “This gel stent is simply the most exciting approach we have had for the surgical treatment of glaucoma for a long, long time,” said Rohit Varma, MD, MPH, interim dean of the Keck School of Medicine, the Grace and Emery Beardsley Professor and Chair of Ophthalmology and director, Roski Eye Institute, University of Southern California. “Once the pressure drops after implanting the stent, it stays low for a number of years.

    Dr. Varma presented unpublished topline data from 12 months of follow up on 103 patients treated by 11 different surgeons across seven European countries.

    Most prior data on the stent has come from combination procedures, Dr. Varma noted. This is one of the largest studies of stand-alone implantation in reducing IOP and medication use in patients primary open-angle glaucoma and no prior incisional surgery, he added.

    Before implantation, patients had a mean best medicated IOP of 22.8 mm Hg. The mean best medicated IOP 12 months after implantation was 13.3 mm Hg, a 42% reduction. Patients in the trial were taking a mean of 3.3 IOP-lowering eye drops before implantation and 1.1 drops 12 months post-implantation, a 66% reduction in medication use.

    “The problem is that glaucoma is a long-term disease and we are treating patients over a lifetime,” Dr. Varma said. “All we have at this point is drops, then laser, which is not particularly effective, then invasive surgery, trabeculectomy, and tubes. There is a real need for a treatment that is more effective than drops, is minimally invasive like laser, and produces clinically significant and consistent reduction in IOP over the long term. That’s where [this deviece] comes in.”

    Fred Gebhart
    The author is a correspondent for Urology Times, a sister publication.

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