Purpose: To assess the effectiveness of XEN45, either alone or in combination with phacoemulsification, in open-angle glaucoma (OAG) patients in clinical practice. Methods: Retrospective and single-center study conducted on OAG patients who underwent XEN45 implant, either alone or in combination with cataract surgery. We compared the clinical outcomes of the eyes of thosewho underwent XEN-solo versus those who underwent XEN+Phacoemulsification. The primary endpoint was the mean change in intraocular pressure (IOP) from baseline to the last follow-up visit. Results: A total of 154 eyes, 37 (24.0%) eyes that underwent XEN-solo and 117 (76.0%) eyes that underwent XEN+Phacoemulsification, were included. The mean preoperative IOP was significantly lowered from 19.1± 5.0 mmHg to 14.9± 3.8 mmHg at month-36, p< 0.0001. Preoperative IOP was significantly lowered from 21.2± 6.2 mmHg and 18.4± 4.3 mmHg to 14.3± 4.0 mm Hg and 15.2± 3.7 mmHg at month-36 in the XEN-solo and XEN+Phacoemulsification groups, p< 0.0004 and p=0.0009; with no significant differences between them. In the overall study population, the mean number of antiglaucoma medications was significantly reduced from 2.1± 0.8 to 0.2± 0.6, p< 0.0001. There were no significant differences in the proportion of eyes with a final IOP ≤ 14 mmHg and ≤ 16 mmHg between XEN-solo and XEN+Phaco groups (p=0.8406 and 0.04970, respectively). Thirty-six (23.4%) eyes required a needling procedure. Conclusion: XEN implant significantly lowered IOP and reduced the need of ocular hypotensive medication, while maintaining a good safety profile. Beyond week-1, there were no significant differences in IOP lowering between XEN-solo and XEN+Phacoemulsification groups.

Background: The aim of this study was to evaluate the short-term efficacy and safety of the Paul Glaucoma Implant (PGI) in pediatric eyes diagnosed with glaucoma following congenital cataract surgery (GFCS). Methods: A retrospective, single-center, descriptive study was conducted on consecutive children diagnosed with GFCS who underwent PGI implantation between July 2022 and November 2023 at the University Medical Center Mainz. The primary outcome measure was the reduction in IOP at the last follow-up visit. Results: Ten eyes of nine children were included in the study. The mean follow-up time was 7.70 ± 4.22 months (4.68–10.72 months). At the end of the study follow-up, the mean (95% CI) reduction in IOP was −14.8 ± 8.73 mmHg (−8.56 to −21.04 mmHg, p < 0.001). At the last follow-up, 30.0% (3/10) of patients achieved an IOP (intraocular pressure) of ≥6 and ≤21 mmHg with a reduction in IOP of ≥25% without treatment, while 90.0% (9/10) achieved this target IOP regardless of glaucoma medication treatment. The mean number of antiglaucoma medications was significantly reduced from 3.50 (IQR = 1) to 2.0 (IQR = 2, p = 0.01), and the visual acuity logMAR improved from 1.26 ± 0.62 to 1.03 ± 0.48 (p = 0.04). Only one eye experienced numerical hypotony (4 mmHg) without choroidal detachment or anterior chamber shallowing within the first 24 h. No other adverse events were observed during the follow-up period. Conclusions: PGI implantation significantly lowered IOP and the number of antiglaucoma eye drops with a favorable safety profile in children diagnosed with GFCS, thereby achieving a high rate of qualified surgical success in the short term.

This study compares the one-year outcomes of standalone Ahmed glaucoma valve (AGV) implantation and standalone Paul glaucoma implant (PGI) in adult patients with primary and secondary glaucoma. A retrospective, single-center, comparative study was conducted on adult patients who underwent standalone PGI and AGV at the University Medical Center Mainz. The primary outcome measures were the changes of IOP and the number of antiglaucoma eye medication at one year postoperatively. Secondary outcome measures included complete and qualified success rates, failure rates, visual acuity logMAR and the incidence of adverse events. A total of 24 adult patients were included in the AGV group and 28 in the PGI group. The median preoperative intraocular pressure decreased from 29.5mmHg (Interquartile range (IQR) 21–42) to 16.0mmHg (IQR 7–37) in the AGV group, and from 34.0 mmHg (IQR 13–56) to 16.0 (IQR 7–21) mmHg in the PGI group at the one-year follow-up. The median number of classes of intraocular pressure-lowering medications reduced from 3.5 to 0 in the AGV group, and from 3.0 to 0 in the PGI group. There were no statistically significant differences between the groups for any success criteria or failure. The AGV produced more encapsulation than the PGI, and the latter more tube exposures. Both the Ahmed Glaucoma Valve and the Paul Glaucoma Implant effectively reduce IOP and the number of antiglaucoma medications at one year with comparable safety profiles.

To compare iStent inject® W+phacoemulsification with XEN45 implant+phacoemulsification over 12 months in mild to moderate glaucoma patients needing cataract surgery at the Hospital General Universitario Dr. Balmis, Alicante, Spain. Retrospective clinical cohort study. Consecutive patients who underwent phacoemulsification either combined with XEN45 implantation or iStent inject® W from 2020 to 2022 were included. The main outcome measure was surgical success at 12 months postoperatively. Intraocular pressure (IOP), number of antiglaucoma medications, intraoperative and postoperative complications, number of revision surgeries, use of the operating room and required visits were also evaluated. A total of 167 eyes were included in the study, with 101 eyes of 61 patients undergoing iStent+PHACO and 66 eyes of 46 patients undergoing XEN45+PHACO. The proportion of patients achieving a complete success (IOP≥5 and ≤ 18mmHg without medication) at the conclusion of the 12-month follow-up was 47.9% (35/73) in the iStent+PHACO and 48.2% (27/56) in the XEN45+PHACO surgery group, P=1.000. The mean (95% CI) IOP reduction at the conclusion of the study follow-up was -2.4 (-3.5 to -1.3mmHg, P<0.001, iStent+PHACO) and -3.10 (-4.8 to -1.4mmHg, P<0.001, XEN45+PHACO). The mean number of antiglaucoma medications was significantly reduced in both study groups. Rates of intraoperative complications (5 vs. 15.2%), postoperative complications (1 vs. 46.2%), reoperations (0 vs. 24.6%), mean number of operating room visits (1 vs. 1.41), and mean number of required postoperative visits (4.50 vs. 11.13) were all statistically significantly higher in the XEN45+PHACO group (< 0.001). Both procedures achieved similar surgical success rates, with comparable reductions in IOP and the number of antiglaucoma medications. After one year, a modest IOP reduction of 10.83% was observed in the iStent group and 13.65% in the Xen group. However, the iStent inject® W demonstrated a better intraoperative and postoperative safety profile.

Soemmering ring is the capsular remnants of a cataractous lens, which contain some retained cortical cells and newly formed lens substance [1], [2], [3]. These cells and this substance are encysted between the anterior and the posterior capsules of the lens [1], [2], [3]. The epithelium proliferates and lines the posterior capsule and grows around the margin of the anterior capsule [2], [3], [4]. It forms a ring around the periphery of the capsular bag [2]. The nucleus of the lens is, per definition, always absent after either trauma or operative intervention [1], [2]. The fusion between the anterior capsule and the posterior capsule protects the cells and lens fibers from the lytic aqueous humor [3], [4]. The ring is more often formed by several separated irregular masses than by a complete ring structure [2]. It lies in the retro-iridial space [2], [3], [4]. Received: 22 August 2021 Accepted: 16 September 2021 Publication Date: 21 October 2021 (online) © 2021. Thieme. All rights reserved. Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany