Eyeworld

SEPTEMBER 2021 | EYEWORLD | 21 References 1. Tham YC, et al. Global prevalence of glaucoma and projections of glaucoma burden through 2040: a systematic review and meta-analysis. Oph- thalmology. 2014;121:2081–2090. 2. Chu CK, et al. Reoperations for complications within 90 days after glaucoma surgery. J Glaucoma. 2020;29:344–346. 3. Tan NE, et al. Comparison of safety and efficacy between ab interno and ab externo approaches to XEN Gel Stent placement. Clin Ophthalmol. 2021;15:299–305. 4. Ahmed IIK, et al. Three-year findings of the HORIZON trial: a Schlemm canal microstent for pressure reduction in primary open-angle glaucoma and cataract. Ophthalmology. 2021;128:857–865. 5. Ahmed IIK, et al. A prospective randomized trial comparing Hydrus and iStent microinvasive glaucoma surgery implants for standalone treatment of open-angle glaucoma: the COMPARE study. Ophthalmolo- gy. 2020;127:52–61. 6. Gazzard G, et al. Selective laser trabeculoplasty versus eye drops for first-line treatment of ocular hypertension and glaucoma (LiGHT): a multicentre randomised controlled trial. Lancet. 2019;393:1505–1516. interno approach. The most common indication for reoperation with XEN was high IOP, which is similar to other MIGS, but this group also had bleb-related indications for reoperation. Of these, 2.6% required reoperation for implant exposure or wound leak. This can be compared to a rate of tube exposure of 1.6% and rate of wound leak of 1.8% in the immediate postoper- ative period. 2 Discussion The ASCRS Journal Club panelists highlighted the large number of MIGS procedures per- formed by a diverse group of surgeons as two great strengths of this study. Given this study's retrospective nature, there was no standardized protocol among the study groups. Medical and surgical deci- sions were individualized to each patient and was a statistically significant reduction in IOP, improvement in visual acuity, and decrease in number of IOP-lowering drops at postoperative month 1. Across groups, there were no visually devastating complications in the 90-day postop- erative period. Summary The 90-day reoperation rate for MIGS in this study was 5.3%. The most common indication for reoperation was elevated IOP. If elevated IOP is excluded as an indication for reoperation as in prior studies, the reoperation rate for MIGS in this study was 1.6%. This rate is lower than the 90-day reoperation rate of 2.5–3.1% for traditional glaucoma surgeries reported by Chu et al. 2 The XEN group had a statistically signifi- cant higher rate of reoperation rate of 10.5%. Reoperation was more common with the ab continued on page 22 Drs. Ray, Linderman, and Chow Source: Yale Eye Center

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