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Tytuł:
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Needling and open filtering bleb revision after XEN-45 implantation-a retrospective outcome comparison.
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Autorzy:
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Steiner S; Department of Ophthalmology and Optometry, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
Resch H; Department of Ophthalmology and Optometry, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
Kiss B; Department of Ophthalmology and Optometry, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
Buda D; Department of Ophthalmology and Optometry, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
Vass C; Department of Ophthalmology and Optometry, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria. .
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Źródło:
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Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie [Graefes Arch Clin Exp Ophthalmol] 2021 Sep; Vol. 259 (9), pp. 2761-2770. Date of Electronic Publication: 2021 May 11.
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Typ publikacji:
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Journal Article
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Język:
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English
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Imprint Name(s):
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Original Publication: Berlin ; New York : Springer-Verlag, c1982-
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MeSH Terms:
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Glaucoma Drainage Implants*
Trabeculectomy*
Humans ; Intraocular Pressure ; Retrospective Studies ; Tonometry, Ocular ; Treatment Outcome
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References:
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Contributed Indexing:
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Keywords: Bleb revision; Filtering surgery; Glaucoma surgery; MIGS; Needling; XEN
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Entry Date(s):
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Date Created: 20210512 Date Completed: 20230420 Latest Revision: 20230420
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Update Code:
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20240105
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PubMed Central ID:
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PMC8380566
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DOI:
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10.1007/s00417-021-05204-1
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PMID:
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33977318
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Purpose: To compare efficacy and safety of needling and open bleb revision after XEN-45 surgery.
Methods: This retrospective study represents real-life data of patients who underwent XEN-45 surgery between November 2014 and June 2018 in the Vienna General Hospital. The following groups were formed for data evaluation: (PSEA) primary surgery secondary intervention allowed (n = 268); (PS) primary surgery until secondary intervention (n = 268); (N) first needling until additional secondary intervention (n = 55); (BR) first bleb revision until additional secondary intervention (n = 105). Main outcome measures were pre- and postoperative intraocular pressure (IOP), number of glaucoma medication (GM), Kaplan-Meier success rates, and secondary intervention rates. Success was defined as postoperative IOP < 21 mmHg and < 18 mmHg together with ≥ 20% IOP reduction with medication allowed.
Results: IOP (and GM) was lowered from 23.5 ± 8.0 (GM 3.1 ± 1.0) to 14.9 ± 8.2 mmHg (1.2 ± 1.4) in group PSEA and 18.1 ± 8.2 mmHg (1.5 ± 1.4) in group PS, in group N from 23.2 ± 10.1 (1.5 ± 1.0) to 19.3 ± 8.5 mmHg (2.2 ± 1.3) and in group BR from 22.0 ± 8.0 mmHg (2.5 ± 1.1) to 15.5 ± 6.4 mmHg (1.3 ± 1.5) after a median follow-up of 16.0, 8.4, 4.8, and 7.3 months, respectively. Success rates at 1 year were significantly higher in group BR (50.7%) compared to PS (37.7%, p = 0.019) and N (24.3%; p = 0.015). An additional intervention was required less frequently in group BR (17.1%) compared to group PS (49.6%, p < 0.001) and group N (54.5%, p < 0.001).
Conclusion: Our data appear to indicate favorable outcomes for open XEN bleb revision in terms of Kaplan-Meier success rates and secondary intervention rate compared to the needling procedure.
(© 2021. The Author(s).)
