Comparative efficacy and safety of ab-interno XEN 45 gel implantation versus trabeculectomy for glaucoma: a systematic review and meta-analysis.
Background: Trabeculectomy remains the standard surgical treatment for glaucoma, but is associated with postoperative complications. XEN gel stent implantation has emerged as a minimally invasive alternative, though comparative evidence regarding its efficacy and safety remains inconsistent. Objecti...
| Publicado en: | Therapeutic Advances in Ophthalmology Vol. 18; pp. 1 - 16 |
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| Autores principales: | , , , , , , , |
| Formato: | research systematic review tables/charts Journal Article |
| Publicado: |
Sage Publications Inc.
7/30/2026
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=195832065&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 195832065 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 25158414 LAW0 jtl: Therapeutic Advances in Ophthalmology issn: 25158414 maglogo: Y pubinfo: dt: 7/30/2026 vid: 18 pid: 344 pub: Sage Publications Inc. place: Thousand Oaks, California artinfo: ui: 195832065 195832065 195832065 10.1177/25158414261472730 195832065 ppf: 1 ppct: 15 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Comparative efficacy and safety of ab-interno XEN 45 gel implantation versus trabeculectomy for glaucoma: a systematic review and meta-analysis. aug: au: Bhatti, Muhammad Imaz Qadri, Maria Asif, Ariba Iftikhar, Sana Safiullah, Muhammad Habib, Erum Abu Dawood, Husam Serhan, Hashem Abu affil: Conceptualization, Faculty of Medicine, King Edward Medical University, Lahore, Pakistan sug: subj: Patient Safety Trabeculectomy Glaucoma Surgery Treatment Outcomes Evaluation Stents Human Meta Analysis Systematic Review PubMed Embase Cochrane Library Checklists Comparative Studies Odds Ratio Confidence Intervals Intraocular Pressure Antiglaucoma Agents Eye Hemorrhage Reoperation Endophthalmitis Postoperative Complications Uveal Diseases Descriptive Statistics Data Analysis Software ab: Background: Trabeculectomy remains the standard surgical treatment for glaucoma, but is associated with postoperative complications. XEN gel stent implantation has emerged as a minimally invasive alternative, though comparative evidence regarding its efficacy and safety remains inconsistent. Objectives: To compare the efficacy and safety of ab-interno XEN 45 gel stent implantation versus trabeculectomy in patients with glaucoma. Design: Systematic review and meta-analysis. Data sources and methods: A comprehensive literature search was conducted across PubMed, Embase, Scopus, the Cochrane Library, and Web of Science to identify studies comparing the XEN Gel Stent with trabeculectomy. Random-effects meta-analyses were performed using odds ratios (ORs) and mean differences (MDs) with 95% confidence intervals (CIs). Results: Eleven studies comprising 1260 eyes (645 XEN, 615 trabeculectomy) were included. Trabeculectomy achieved significantly greater intraocular pressure (IOP) reduction (MD: −2.16 mmHg (95% CI: −2.88 to -1.44); I 2 = 43%) and higher qualified (OR: 1.59 (95% CI: 1.18 to 2.14); I 2 = 0%) and complete surgical success rates (OR: 1.72 (95% CI: 1.16 to 2.56); I 2 = 43%). No significant difference was observed in the number of antiglaucoma medications (MD: −0.03 (95% CI: −0.23 to 0.18); I 2 = 53%). Rates of hyphema, choroidal detachment, hypotony, flat anterior chamber, bleb revision, and reoperation showed no statistically significant differences between procedures, although substantial heterogeneity was observed for hyphema (I 2 = 60%), hypotony (I 2 = 76%), and reoperation (I 2 = 53%). XEN demonstrated significantly lower risks of bleb leakage and endophthalmitis but higher rates of bleb needling. Conclusion: Trabeculectomy achieves greater intraocular pressure reduction and higher surgical success rates than ab-interno XEN45 gel stent implantation, whereas XEN is associated with lower rates of selected bleb-related complications. Procedure selection should be individualized according to target intraocular pressure, glaucoma severity, and postoperative management requirements. Trial registration: PROSPERO (CRD420251075034). pubtype: Academic Journal doctype: meta analysis research systematic review tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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