Journal d'ophtalmologie clinique et expérimentale
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Comparison of Clinical Outcomes between XEN Gel Stent and PreserFlo Microshunt: A Monocentric Experience

Fabrizio Giansanti, Giuseppe Quaranta, Federica Serino, G Vicini, Fabrizio Franco

Purpose: To compare the clinical efficacy and safety outcomes in patients with Primary Open Angle Glaucoma (POAG) who underwent PreserFlo microshunt implantation and XEN-45 gel stent implantation at a single center.

Materials and methods: This is a monocentric retrospective study on patients with POAG treated with XEN-45 gel stent implantation or PreserFlo minishunt implantation at our centre in Florence. We included 31 eyes in 24 patients with XEN-45 and 26 eyes treated with twenty-six eyes in 25 patients with PreserFlo microshunt. All patients underwent a complete preoperative assessment, which included Intraocular Pressure (IOP) measurement with Goldmann Applanation Tonometry (GAT). Follow-up lasted for 12 months.

Results: We included 31 eyes treated with XEN-45 gel stent and 26 eyes treated with PreserFlo microshunt. The probability of complete success, meant as IOP ≤ 18 mmHg at month 12 without the need for surgically revising the bleb or reoperation, was of 51.6% in group 1 (XEN45) and 65.3% in group 2 (PreserFlo), without statistically significant difference (P=0.294). IOP dropped from 17.84 ± 4.48 to 13.48 ± 2.55 at month 12 in group XEN45, and from 17.27 ± 4.23 to 13.31 ± 1.54 at month 12 in group PreserFlo (P=0.760). The number of IOP-lowering medications dropped from 2.45 ± 1.26 to 0.24 ± 0.66 (month 12) in the XEN45 group and from 2.65 ± 0.89 to 0.24 ± 0.66 (month 12) in the PreserFlo group, without statically significant differences (P=0.642). Needling rate was 35.4% in group 1 and 11.5% in group 2 (P=0.036).

Conclusion: In our experience, both XEN45 gel stent and PreserFlo microshunt demonstrated to be effective and safety with similar results in terms of IOP-lowering and surgical success.