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      Xen 63 versus Preserflo MicroShunt implant in patients with primary open-angle glaucoma

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          Abstract

          This study compared the efficacy safety profiles of the Xen 63 and Preserflo MicroShunt devices, both standalone, in patients with primary open-angle glaucoma (POAG). It is a retrospective and single-center study conducted on consecutive on patients with medically uncontrolled POAG who underwent either a standalone Xen 63 or a standalone Preserflo and had a 12-month follow-up visit. The primary outcome was the mean IOP at month-12. Sixty eyes were included, 30 eyes in each Xen 63 and Preserflo groups, respectively. Preoperative IOP was significantly lowered from 20.8 ± 3.6 mmHg and 19.1 ± 3.8 mmHg to 14.2 ± 4.5 mmHg and 12.8 ± 2.3 mmHg in the Xen 63 and Preserflo groups, respectively ( p < 0.0001 each, respectively); without significant differences between groups ( p = 0.1346). Preoperative number of ocular-hypotensive drugs was significantly reduced from 2.3 ± 0.6 to 0.2 ± 06 drugs and from 2.3 ± 0.7 to 0.3 ± 0.6 drugs, in the Xen 63 and Preserflo groups, respectively ( p < 0.0001 each, respectively); without significant differences between groups ( p = 0.5212). Regarding safety, one (3.3%) eye in the Preserflo group required a device removal due to maculopathy. Three (10.0%) eyes in the Xen 63 group underwent needling. In conclusion, both the Xen 63 and the Preserflo devices effectively and safely reduced IOP and the requirement for IOP-lowering medications, exhibiting comparable IOP levels after 12 months.

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          Most cited references28

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          Reduction of intraocular pressure and glaucoma progression: results from the Early Manifest Glaucoma Trial.

          To provide the results of the Early Manifest Glaucoma Trial, which compared the effect of immediately lowering the intraocular pressure (IOP), vs no treatment or later treatment, on the progression of newly detected open-angle glaucoma. Randomized clinical trial. Two hundred fifty-five patients aged 50 to 80 years (median, 68 years) with early glaucoma, visual field defects (median mean deviation, -4 dB), and a median IOP of 20 mm Hg, mainly identified through a population screening. Patients with an IOP greater than 30 mm Hg or advanced visual field loss were ineligible. Patients were randomized to either laser trabeculoplasty plus topical betaxolol hydrochloride (n = 129) or no initial treatment (n = 126). Study visits included Humphrey Full Threshold 30-2 visual field tests and tonometry every 3 months, and optic disc photography every 6 months. Decisions regarding treatment were made jointly with the patient when progression occurred and thereafter. Glaucoma progression was defined by specific visual field and optic disc outcomes. Criteria for perimetric progression were computer based and defined as the same 3 or more test point locations showing significant deterioration from baseline in glaucoma change probability maps from 3 consecutive tests. Optic disc progression was determined by masked graders using flicker chronoscopy plus side-by-side photogradings. After a median follow-up period of 6 years (range, 51-102 months), retention was excellent, with only 6 patients lost to follow-up for reasons other than death. On average, treatment reduced the IOP by 5.1 mm Hg or 25%, a reduction maintained throughout follow-up. Progression was less frequent in the treatment group (58/129; 45%) than in controls (78/126; 62%) (P =.007) and occurred significantly later in treated patients. Treatment effects were also evident when stratifying patients by median IOP, mean deviation, and age as well as exfoliation status. Although patients reported few systemic or ocular conditions, increases in clinical nuclear lens opacity gradings were associated with treatment (P =.002). The Early Manifest Glaucoma Trial is the first adequately powered randomized trial with an untreated control arm to evaluate the effects of IOP reduction in patients with open-angle glaucoma who have elevated and normal IOP. Its intent-to-treat analysis showed considerable beneficial effects of treatment that significantly delayed progression. Whereas progression varied across patient categories, treatment effects were present in both older and younger patients, high- and normal-tension glaucoma, and eyes with less and greater visual field loss.
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            Primary open-angle glaucoma.

            Glaucoma is an optic neuropathy that is characterized by the progressive degeneration of the optic nerve, leading to visual impairment. Glaucoma is the main cause of irreversible blindness worldwide, but typically remains asymptomatic until very severe. Open-angle glaucoma comprises the majority of cases in the United States and western Europe, of which, primary open-angle glaucoma (POAG) is the most common type. By contrast, in China and other Asian countries, angle-closure glaucoma is highly prevalent. These two types of glaucoma are characterized based on the anatomic configuration of the aqueous humour outflow pathway. The pathophysiology of POAG is not well understood, but it is an optic neuropathy that is thought to be associated with intraocular pressure (IOP)-related damage to the optic nerve head and resultant loss of retinal ganglion cells (RGCs). POAG is generally diagnosed during routine eye examination, which includes fundoscopic evaluation and visual field assessment (using perimetry). An increase in IOP, measured by tonometry, is not essential for diagnosis. Management of POAG includes topical drug therapies and surgery to reduce IOP, although new therapies targeting neuroprotection of RGCs and axonal regeneration are under development.
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              • Article: not found

              The Most Common Barriers to Glaucoma Medication Adherence: A Cross-Sectional Survey.

              To evaluate the frequency of 11 commonly cited barriers to optimal glaucoma medication adherence among glaucoma patients and to identify barriers contributing to poor adherence.
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                Author and article information

                Contributors
                jmmartinezcasa@gmail.com
                Journal
                Sci Rep
                Sci Rep
                Scientific Reports
                Nature Publishing Group UK (London )
                2045-2322
                10 January 2025
                10 January 2025
                2025
                : 15
                : 1634
                Affiliations
                Department of Ophthalmology and ORL, Faculty of Medicine, Clinico San Carlos Hospital, Complutense University, Clinico San Carlos Hospital Health Research Institute (IdISSC), ( https://ror.org/04d0ybj29) Calle del Prof Martín Lagos, s/n,, Madrid, 28040 Spain
                Article
                81616
                10.1038/s41598-024-81616-3
                11723952
                39794378
                0197e17a-e15c-4806-8acb-21a71f5d80ae
                © The Author(s) 2025

                Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/.

                History
                : 27 July 2024
                : 14 November 2024
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                © Springer Nature Limited 2025

                Uncategorized
                xen 63,preserflo,microshunt,glaucoma,migs,iop,ocular hypertension
                Uncategorized
                xen 63, preserflo, microshunt, glaucoma, migs, iop, ocular hypertension

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