In vivo confocal microscopy: qualitative investigation of the conjunctival and corneal surface in open angle glaucomatous patients undergoing the XEN-Gel implant, trabeculectomy or medical therapy

Eye and Vision

Simone Alex Bagaglia¹  Leonardo Ciompi¹  Arianna Sgheri¹  Alessandro Di Maggio¹  Cosimo Mazzotta¹  Matteo Posarelli¹  Gian Marco Tosi¹  Stefano Baiocchi¹  Alessandro Meduri² 

[1] Department of Medicine, Surgery and Neurosciences, Ophthalmology Unit, Policlinico Santa Maria alle Scotte, University of Siena;Ophthalmology Unit, Department of Biomedical Sciences, University of Messina;

关键词: Glaucoma;    Primary open angle glaucoma;    POAG;    MIGS;    Xen 45 gel stent;    Ocular surface;   

DOI  :  10.1186/s40662-020-00181-8

来源: DOAJ

【 摘 要 】

Abstract Purpose Assessing the quality of the ocular surface by in vivo scanning laser confocal microscopy (IVCM) in primary open angle glaucoma (POAG) patients treated by Xen 45 Gel Stent, medical therapy and trabeculectomy. Methods Retrospective, single-center, single-masked, comparative study including 60 eyes of 30 patients (mean age 61.16 ± 10 years) affected by POAG. Eyes were divided into 3 groups: Group 1 eyes underwent the Xen 45 Gel Stent procedure, Group 2 eyes were under medical therapy, Group 3 eyes were surgically treated by trabeculectomy. All patients underwent HRT II IVCM analysis of cornea, limbus, conjunctiva, sub-tenionian space and sclera. Results The Xen 45 Gel stent, if properly positioned in the sub-conjunctival space preserves goblet cells and limits ocular surface inflammation. Regular corneal epithelial cells with micro-cysts, and normo-reflective sub-epithelial nerve plexus are documented by IVCM. In sub Tenon’s implants an alternative lamellar intra-scleral filtration is detectable. Combined surgical procedures show a noticeable number of inflammatory cells with rare micro-cysts. Post-trabeculectomy inflammatory reaction is more evident than Xen 45 Gel Stent associated surgical procedures, but less than medical therapy where a conspicuous presence of Langerhans cells, peri-neural infiltrates, marked loss of goblet cells and fibrosis is visible. Conclusion Ocular surface inflammation was more notable in topical therapy than after trabeculectomy, which itself causes more inflammation than XEN Gel stents.

【 授权许可】

Unknown