Purpose: Compare efficacy and safety of standalone ab interno gelatin microstent versus trabeculectomy 3 years post-operative. There is currently no published long-term data on XEN, nor long-term comparative data versus trabeculectomy. 

Methods: Primary outcome was time to failure (IOP outside of 6-17 on no medications) on two consecutive visits despite in-clinic maneuvers (including needling). Secondary outcomes included IOP cutoffs of 14 and 21, interventions, complications, and reoperations.

Results: 69 eyes received trabeculectomy and 100 eyes received microstent. HR for trabeculectomy relative to microstent was 1.03 (95% CI 0.67-1.56); proportional success at 1/2/3 years were 0.76 (0.07), 0.66 (0.07), 0.58 (0.08) for trabeculectomy and 0.77 (0.06), 0.69 (0.07), 0.63 (0.07) for microstent. There were 79 and 64 interventions (40.6% and 44% had needling), and 47 and 32 complications (most were transient), respectively. 11.6% and 14% received reoperation.

Conclusion: Standalone ab interno gelatin microstent showed excellent success rate and safety profile at 3 years post-operative follow-up, comparable to standalone trabeculectomy.

Efficacy & safety of standalone ab interno gelatin microstent implantation with MMC vs. Trabeculectomy with MMC: 3 years follow up

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