TY - JOUR T1 - Trabeculectomy versus Xen gel implant for the treatment of open-angle glaucoma: a 3-year retrospective analysis JF - BMJ Open Ophthalmology JO - BMJ Open Ophth DO - 10.1136/bmjophth-2021-000830 VL - 7 IS - 1 SP - e000830 AU - Francesca Cappelli AU - Carlo Alberto Cutolo AU - Sara Olivari AU - Valeria Testa AU - Daniele Sindaco AU - Chiara Pizzorno AU - Sara Ciccione AU - Carlo Enrico Traaverso AU - Michele Iester Y1 - 2022/01/01 UR - http://bmjophth.bmj.com/content/7/1/e000830.abstract N2 - Objective To compare the two surgical techniques in terms of efficacy, safety, and postoperative management over 36 months of follow-up.Methods This retrospective clinical cohort study compared the outcome of trabeculectomy surgery and Xen gel implant in patients having uncontrolled glaucoma. Patients were recruited using the following inclusion criteria: uncontrolled intraocular pressure (IOP) on maximally tolerated medical therapy, healthy conjunctiva freely mobile in the superior sector, open-angle, glaucomatous visual field damage, full follow upfollow-up of at least 36 months. Thirty-four patients were submitted to trabeculectomy and 34 to Xen gel implant. We set the lower limit at 6mmHg mm Hg and the upper limit ≤12 mm Hg for criteria A, upper limit to ≤15 mm Hg for criteria B and upper limit ≤18 mm Hg for criteria C. Criteria for success have been characterizedcharacterised according to whether or not this has been achieved without (complete success) or with IOP -lowering medications (qualified success).Results For all survival curves, trabeculectomy was superior to Xen gel implant. When considering complete success, the log-rank test for criteria A was statistically significant (pp=0.006), marginally significant for criteria B (pp=0.065) and not significant for criteria C (pp=0.23). When qualified success was considered, trabeculectomy was superior to Xen gel for criteria A, B, and C (pp=0.012, pp=0.033 and pp=0.025, respectively). Higher number of post-operative flat chamber and bleb leakage was observed in the trabeculectomy group.Conclusion Xen gel implant techniques offer a better safety profile but a lower IOP reduction compared to compared with the gold -standard technique.Data are available upon reasonable request. ER -