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Post MIGS, Pseudophakic
Not at Target IOP

CASE 1: 76 YEARS OLD, POST TM STENT*

Case provided by:David A. Goldman, MDGoldman Eye, Palm Beach Gardens, FL

 CASE 1: 76 YEARS OLD, POST TM STENT*

Case provided by: David A. Goldman, MDGoldman Eye, Palm Beach Gardens, FL
CASE 2: 75 YEARS OLD, MTMT, POST TM STENT*

Case provided by:Ahad Mahootchi, MD The Eye Clinic, Zephyrhills, FL

 CASE 2: 75 YEARS OLD, MTMT, POST TM STENT*

Case provided by: Ahad Mahootchi, MD The Eye Clinic, Zephyrhills, FL

CASE PRESENTATION

  • 76-year-old woman presents for new patient evaluation
  • History of glaucoma treated by her last surgeon
  • Cataract surgery and TM stent procedure* performed 2 years prior

BASELINES

Exam Findings Exam Findings
Fundus Exam Fundus Exam
OCT RNFL OCT RNFL
Visual Field Test Visual Field Test

ASSESSMENT

  • Severe POAG OU with a history of CE/IOL/TM stent* OU
  • IOP not well controlled
  • Surgeon suspects POAG is progressing
  • Patient reported problems with drops, which led prior surgeon to TM stent*

*In the clinical study, prior surgery only included trabeculectomy, tube shunt, canaloplasty, selective laser trabeculoplasty (SLT), and trabeculotomy.1

TREATMENT DECISION

XEN® Gel Stent implantation OU.

XEN® Gel Stent Post-op Outcomes

CONCLUSION

  • IOP was successfully lowered OU with XEN® Gel Stent after
    previous CE/IOL/TM stent* OU
  • The patient no longer needs drops

To learn more about identifying patients who could benefit
from XEN® Gel Stent, contact your Allergan representative.

CE = cataract extraction; IOL = intraocular lens; IOP = intraocular pressure; MIGS = minimally invasive glaucoma surgery; MTMT = maximum tolerated medical therapy; OCT = optical coherence tomography;
PCIOL = posterior chamber intraocular lens; POAG = primary open-angle glaucoma; RNFL = retinal nerve fiber layer; TM = trabecular meshwork.

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CASE PRESENTATION

  • 75-year-old White male
  • Pseudophakic OU with PCIOL and TM stent*
  • One year after surgery, IOP was 23 mm Hg OS with severe progression of VF loss after IOP-lowering medications were tapered by another doctor
  • Was losing VF at IOP of 18 mm Hg. The field loss was approaching
    fixation, but the patient still had good central vision

BASELINES

EXAM FINDINGS OS

ASSESSMENT

  • Patient stated issues affording medications
  • Pseudophakic patient with refractory glaucoma; potential concern with incisional glaucoma procedure is alteration of refractive state, compromising premium IOL function
  • Laser surgery and other surgery was not considered due to the low goal IOP needed

*In the clinical study, prior surgery only included trabeculectomy, tube shunt, canaloplasty, selective laser trabeculoplasty (SLT), and trabeculotomy.1

TREATMENT DECISION

XEN® Gel Stent implantation OS.

XEN® Gel Stent Post-op Outcomes

CONCLUSION

  • XEN® Gel Stent maintained IOP with 1 IOP-lowering medication
    1 year postoperatively
  • Prednisolone was tapered slowly over 3 months

To learn more about identifying patients who could benefit
from XEN® Gel Stent, contact your Allergan representative.

IOP = intraocular pressure; MIGS = minimally invasive glaucoma surgery; MTMT = maximum tolerated medical therapy; PCIOL = posterior chamber intraocular lens; TM = trabecular meshwork; VF = visual field.

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