Assessing XEN microstent's one-year efficacy: independent of site variability

AIM: To evaluate the short-term efficacy of XEN45 Gel Stent (XEN) implantation for primary open angle glaucoma (POAG) and pseudoexfoliation (PEX) glaucoma across two university eye clinics, aiming to assess the impact of varying center-specific protocols during the first postoperative year. METHODS: We retrospectively examined 282 patients (183 in center 1, 99 in center 2), who underwent XEN microstent implantation for uncontrolled POAG or PEX glaucoma. Parameters including intraocular pressure (IOP), IOP-lowering medication count, best corrected visual acuity (BCVA), and postoperative complications were evaluated over 12mo. RESULTS: Post-implantation, center 1 reported a mean IOP reduction from 25.3 +/- 7.4 to 14.1 +/- 4.7 mm Hg (P<0.01) and a decrease in IOP-lowering medications from 3.2 +/- 1.2 to 1.0 +/- 1.3 (P<0.01). Center 2 observed a similar reduction from 24.4 +/- 6.5 to 15.1 +/- 5.5 mm Hg (P<0.01) and medication decrease from 3.0 +/- 1.1 to 1.2 +/- 1.0 (P<0.01). BCVA remained stable in both cohorts. The most common complications were hypotony (center 1: 32; center 2: 20) and choroidal detachment (center 1: 22, center 2: 15), with nearly identical needling rates (40% in center 1, 41% in center 2). CONCLUSION: XEN implantation yields consistent reductions in IOP and medication use across different centers using comparable surgical and postoperative treatment regime. These findings underscore XEN's shortterm effectiveness and suggest standardizable outcomes regardless of exact surgical procedure or treatment differences.