Microinvasive Glaucoma Surgery (MIGS) Gets Bigger: The XEN63
Title of Article: Outcomes of XEN 63 Device at 18-Month Follow-Up in Glaucoma Patients: A Two-Center Retrospective Study.
What are the key takeaway points from this article?
Microinvasive Glaucoma Surgery (MIGS) is a rapidly advancing field, especially since the first MIGS device, the Glaukos iStent, received Health Canada approval in 2010. Since then there have been dozens of microinvasive glaucoma devices that have been developed including the XEN Gel Stents by Allergan. Initially only the XEN45 micron lumen was commercially available, however on September 27th, 2022, the XEN63 became publicly available. This may be clinically significant, as many glaucoma specialists were reporting high rates of bleb failure, revision, and re-needling of the XEN45, which may have been due to the smaller lumen diameter.
Prior to being commercially available, a retrospective clinical study with 23 participants was conducted on patients that underwent XEN 63 implantation either alone or in combination with phacoemulsification. The XEN63 device uses the same needle injector, to prevent side flow around the stent and hypotony. The study showed that the device significantly lowered IOP from 27.0 ± 7.8mmHg to 14.1 ± 3.4 mmHg at 18 months (p < 0.0001) and and reduced the need for ocular hypotensive medications from 2.3 at baseline to 1.0 (p = 0.002) respectively. While future studies are required to compare the safety profile and efficacy of the XEN63 compared to the XEN45 and similar devices such as the PreserFlo 70 micron lumen, early results are promising.
Publication Date: June 2022
Fea A. M. Outcomes of XEN 63 Device at 18-Month Follow-Up in Glaucoma Patients: A Two-Center Retrospective Study. J. Clin. Med. 2022, 11(13), 3801. doi: 10.3390/jcm11133801. Published: 30 June 2022.
Summary by: Andrew Robart