XEN® 45 en el manejo quirúrgico del glaucoma en fases tempranasestudio nacional de consenso según metodología Delphi
- José Manuel Larrosa-Povés 12
- José María Martínez-De-La-Casa 34
- R. Giménez Gómez 5
- Francisco Javier Goñi 6
- E. Milla Griñó 78
- Marta Pazos 78
- Susana Perucho-Martínez 91012
- J.A. Urcola Carrera 11
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Hospital Miguel Servet
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Instituto de Investigación Sanitaria Aragón
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Instituto de Investigación Sanitaria Aragón
Zaragoza, España
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Hospital Clínico San Carlos de Madrid
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Universidad Complutense de Madrid
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Hospital Universitario Reina Sofia
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Fundació Hospital de Mollet
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Fundació Hospital de Mollet
Mollet del Valles, España
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Hospital Clinic Barcelona
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Institut d'Investigacions Biomèdiques August Pi i Sunyer
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Institut d'Investigacions Biomèdiques August Pi i Sunyer
Barcelona, España
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Hospital de Fuenlabrada
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Universidad Rey Juan Carlos
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Hospital Universitario Araba
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Universidad del País Vasco/Euskal Herriko Unibertsitatea
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Universidad del País Vasco/Euskal Herriko Unibertsitatea
Lejona, España
ISSN: 0365-6691
Year of publication: 2024
Volume: 99
Issue: 3
Pages: 98-108
Type: Article
More publications in: Archivos de la Sociedad Española de Oftalmologia
Abstract
Background and objective Recommendations on general glaucoma management and the use of early minimally invasive and microincisional surgeries are limited. This study aimed to establish consensus regarding glaucoma management, focusing on the XEN-45 gel stent implant. Methods A Delphi consensus-driven process was used. The scientific committee led the study, identified the expert panel, and participated in elaborating the questionnaire. Fifty-one panelists were invited to complete, on a nine-point Likert scale, an 89-item questionnaire covering three topic blocks. Two Delphi rounds were performed. Consensus was achieved if ≥66.6% of panelists reached agreement or disagreement. Results Panelists agreed on 84 items related to the patients’ quality of life, the therapeutic algorithm and patient profile, and surgical and pre- and post-operative management. Panelists agreed on the suitability of XEN stent implants to treat glaucoma at different stages and for different patient profiles: young patients, elderly or with significant comorbidities, and with myopic glaucoma, patients who failed previous surgeries, and with previous poor post-operative experience. XEN surgery was considered a therapeutic step prior to classic filtering surgery and a possible first surgical option in elderly patients with comorbidities and uncontrolled intraocular pressure. XEN surgery allows the patient to return to routine daily activities faster than conventional filtering surgeries and to reduce and/or eliminate topical treatments. Conclusions This Delphi-driven consensus resulted in a series of general recommendations for glaucoma management, including those related to patient quality of life, therapeutic algorithm, and patient profile, and specific ones regarding the use of XEN stent gel surgery.