Posture-induced Changes in Intraocular Pressure After Ab Externo XEN45 Gel-stent Implantation in Patients with Primary Open-angle Glaucoma

Overview

Journal BMC Ophthalmol

Publisher Biomed Central

Specialty Ophthalmology

Date 2022 Dec 29

PMID 36581827

Authors

Hyung Nam Jin

Jeong Woo Nam

Haowei Zhang

Mi Sun Sung

Sang Woo Park

Affiliations

Soon will be listed here.

Abstract

Background: To investigate posture-induced changes in intraocular pressure (IOP) after ab externo XEN45 Gel-Stent implantation in patients with medically uncontrolled primary open-angle glaucoma (POAG).

Methods: This prospective study included thirty-two eyes with POAG that underwent XEN45 Gel-Stent implantation as a standalone procedure using an ab externo approach at Chonnam National University Hospital. IOP was measured sequentially in the sitting position, supine position, and lateral decubitus position (LDP) before and at 1, 2, 3, and 6 months after surgery using an iCare IC200 rebound tonometer. In the LDP, the eye with XEN45 Gel-Stent implantation was in the dependent position.

Results: IOP at each position was significantly reduced after XEN45 Gel-Stent implantation. Posture-induced changes in IOP were maintained during the follow-up. The range of postural IOP changes was reduced at 1 month; however, no significant change was observed after that point compared with baseline levels.

Conclusions: A XEN45 Gel-Stent inserted using the ab externo approach can reduce IOP in various body positions, but seems to have limited effects on posture-induced changes in IOP in patients with POAG.

Citing Articles

Ensembling U-Nets for microaneurysm segmentation in optical coherence tomography angiography in patients with diabetic retinopathy.

Husvogt L, Yaghy A, Camacho A, Lam K, Schottenhamml J, Ploner S Sci Rep. 2024; 14(1):21520.

PMID: 39277636 PMC: 11401926. DOI: 10.1038/s41598-024-72375-2.

References

Kim K, Jeoung J, Park K, Kim D, Ritch R . Relationship between preferred sleeping position and asymmetric visual field loss in open-angle glaucoma patients. Am J Ophthalmol. 2013; 157(3):739-45. DOI: 10.1016/j.ajo.2013.12.016. View

Lee R, Bouremel Y, Eames I, Brocchini S, Khaw P . The Implications of an Ab Interno Versus Ab Externo Surgical Approach on Outflow Resistance of a Subconjunctival Drainage Device for Intraocular Pressure Control. Transl Vis Sci Technol. 2019; 8(3):58. PMC: 6602120. DOI: 10.1167/tvst.8.3.58. View

Sawada A, Yamamoto T . Effects of trabeculectomy on posture-induced intraocular pressure changes over time. Graefes Arch Clin Exp Ophthalmol. 2012; 250(9):1361-6. DOI: 10.1007/s00417-012-1942-7. View

Eklund A, Johannesson G, Johansson E, Holmlund P, Qvarlander S, Ambarki K . The pressure difference between eye and brain changes with posture. Ann Neurol. 2016; 80(2):269-76. DOI: 10.1002/ana.24713. View

Sheybani A, Lenzhofer M, Hohensinn M, Reitsamer H, Ahmed I . Phacoemulsification combined with a new ab interno gel stent to treat open-angle glaucoma: Pilot study. J Cataract Refract Surg. 2015; 41(9):1905-9. DOI: 10.1016/j.jcrs.2015.01.019. View

Galin M, McIVOR J, MAGRUDER G . Influence of position on intraocular pressure. Am J Ophthalmol. 1963; 55:720-3. View

Aragno V, Labbe A, Brion F, Baudouin C, Hamard P . The Efficacy of Deep Sclerectomy on Posture-induced Intraocular Pressure Changes. J Glaucoma. 2018; 27(7):617-621. DOI: 10.1097/IJG.0000000000000971. View

Mizokami J, Yamada Y, Negi A, Nakamura M . Postural changes in intraocular pressure are associated with asymmetrical retinal nerve fiber thinning in treated patients with primary open-angle glaucoma. Graefes Arch Clin Exp Ophthalmol. 2010; 249(6):879-85. DOI: 10.1007/s00417-010-1565-9. View

Chang P, Wang J, Weng H, Chang S . Cataract surgery reduces intraocular pressure but not posture-induced intraocular pressure changes in patients with angle-closure glaucoma. Sci Rep. 2019; 9(1):14116. PMC: 6773681. DOI: 10.1038/s41598-019-50598-y. View

10.

Galambos P, Vafiadis J, Vilchez S, Wagenfeld L, Matthiessen E, Richard G . Compromised autoregulatory control of ocular hemodynamics in glaucoma patients after postural change. Ophthalmology. 2006; 113(10):1832-6. DOI: 10.1016/j.ophtha.2006.05.030. View

11.

Gillmann K, Bravetti G, Mansouri K . Delayed Obstruction of XEN Gel Stent by Cell Debris in Primary Open-angle Glaucoma: A New Insight into the Pathophysiology of Filtration Device Failure. J Curr Glaucoma Pract. 2020; 13(3):113-115. PMC: 7221242. DOI: 10.5005/jp-journals-10078-1258. View

12.

Lee J, Yoo C, Jung J, Hwang Y, Kim Y . The effect of lateral decubitus position on intraocular pressure in healthy young subjects. Acta Ophthalmol. 2011; 90(1):e68-72. DOI: 10.1111/j.1755-3768.2011.02208.x. View

13.

Kiuchi T, Motoyama Y, Oshika T . Relationship of progression of visual field damage to postural changes in intraocular pressure in patients with normal-tension glaucoma. Ophthalmology. 2006; 113(12):2150-5. DOI: 10.1016/j.ophtha.2006.06.014. View

14.

Longo A, Geiser M, Riva C . Posture changes and subfoveal choroidal blood flow. Invest Ophthalmol Vis Sci. 2004; 45(2):546-51. DOI: 10.1167/iovs.03-0757. View

15.

Panarelli J, Yan D, Francis B, Craven E . XEN Gel Stent Open Conjunctiva Technique: A Practical Approach Paper. Adv Ther. 2020; 37(5):2538-2549. PMC: 7467501. DOI: 10.1007/s12325-020-01278-1. View

16.

Musch D, Gillespie B, Niziol L, Lichter P, Varma R . Intraocular pressure control and long-term visual field loss in the Collaborative Initial Glaucoma Treatment Study. Ophthalmology. 2011; 118(9):1766-73. PMC: 3161134. DOI: 10.1016/j.ophtha.2011.01.047. View

17.

Hirooka K, Tenkumo K, Nitta E, Sato S . Correlation between Intraocular Pressure Fluctuation with Postural Change and Postoperative Intraocular Pressure in Relation to the Time Course after Trabeculectomy. J Ophthalmol. 2014; 2014:801967. PMC: 4127218. DOI: 10.1155/2014/801967. View

18.

. The Advanced Glaucoma Intervention Study (AGIS): 7. The relationship between control of intraocular pressure and visual field deterioration.The AGIS Investigators. Am J Ophthalmol. 2000; 130(4):429-40. DOI: 10.1016/s0002-9394(00)00538-9. View

19.

Schlenker M, Gulamhusein H, Conrad-Hengerer I, Somers A, Lenzhofer M, Stalmans I . Efficacy, Safety, and Risk Factors for Failure of Standalone Ab Interno Gelatin Microstent Implantation versus Standalone Trabeculectomy. Ophthalmology. 2017; 124(11):1579-1588. DOI: 10.1016/j.ophtha.2017.05.004. View

20.

Quaranta L, Biagioli E, Riva I, Tosoni C, Brusini P, Centofanti M . Effect of trabeculectomy and canaloplasty on intra-ocular pressure modifications after postural changes in open-angle glaucoma. Acta Ophthalmol. 2014; 92(6):e498-9. DOI: 10.1111/aos.12470. View