When use XEN?

Identifying patients suitable for XEN

XEN is suited to first line glaucoma surgery (POAG) when drops aren't enough or previous medical treatments have failed.1,2 Patients exhibiting any one, or more, of the following characteristics may be deemed suited to XEN:

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Patient need

(where previous treatments have failed):

 

  1. Difficulty or reluctance to adhere to number of drops4
  2. Interested in a procedure combining cataract surgery with additional IOP lowering4
  3. Anxious about more invasive surgical options5

Medications & QOL considerations

  • Sub-optimally controlled on drops
    • Not at target IOP6
    • Not achieving a 20-30% IOP reduction7
  • Non-adherent to their drops regimen1
  • Intolerant of drops1

Risk of progression or disability 

  • Long life expectancy11
  • High baseline IOP11
  • VF damage ~7 dB at baseline12
  • VFI deterioration of ≥1%/year8
  • VF defect close to fixation13

Manifest progression

  • Functional progression – VFI deterioration of ≥1%/year8
  • Structural progression – RNFL, inner macula and/or optic disc rim thinning9,10

Why use XEN?

  • Significant reduction and sustained mid-to-low teen IOP (p<0.001)4
  • Short duration, micro-incisional procedure (~10 minutes when experienced)1,14
  • Favourable safety suited to first line glaucoma surgery (POAG) where previous medical treatments have failed2,4
More reasons to use XEN
1. XEN directions for use. 2016. 2. Manasses DT and Au L. Ophthalmol Ther 2016; 5(2): 135-46. 3. Neelakantan A et al. J Glaucoma 2004; 13(2): 130-6. 4. Reitsamer H et al. Graefes Arch Clin Exp Ophthalmol 2019; 257(5): 983-96. 5. Vera V et al. US Ophthalmic Rev 2018; 11(1): 38-46. 6. Leske ME et al. Arch Ophthalmol 2003; 121: 48-56. 7. European Glaucoma Society (EGS). Terminology and Guidelines. 4th edition. 2014. 8. Leung CKS et al. Ophthalmology 2011; 118: 1551-7. 9. Miki A et al. J Curr Glaucoma Pract 2012; 6(2): 62-7. 10. Ohnell H et al. Ophthalmology 2016; 123(6): 1173-80. 11. Ernest PJ et al. Ophthalmology 2013; 120(3): 512-9. 12. Chauhan BC et al. Invest Ophthalmol Vis Sci 2014; 55(7): 4135-43. 13. Membrey WL et al. Br J Ophthalmol 2000; 84(10): 1154-8. 14. Dapena CL and Ros RC. Revista Española de Glaucoma e Hipertensión Ocular 2015; 5(3): 350-7.