As a national leader in innovative ophthalmology treatments that prevent blindness, a team from the USC Gayle and Edward Roski Eye Institute became the first in Los Angeles County to implant the XEN gel stent in glaucoma patients on March 9. The XEN gel stent was approved by the U.S. Food and Drug Administration in November 2016. It became available for implantation in patients nationwide in February.
The half-dozen glaucoma stent implant procedures for Los Angeles-area patients were performed by USC Roski Eye Institute ophthalmologists Alena Reznik, MD, and Sahar Bedrood, MD, PhD, assistant professor of clinical ophthalmology at the Keck School of Medicine of USC.
The XEN gel stent is made of non-degradable soft collagen-derived gelatin and is a minimally invasive, outpatient surgical option for glaucoma patients whose intra-ocular pressure (IOP) cannot be managed by medications or laser treatment. It allows glaucoma patients to avoid more invasive surgical procedures such as trabeculectomy and tube shunt surgeries. The XEN gel stent lets eye fluid drain from inside the eye to under the clear skin of the eye on the outside, reducing elevated eye pressure that can eventually lead to blindness if not alleviated.
“The XEN gel stent is a unique device that conforms to the ocular tissue and is successful at fluid drainage and reducing eye pressure while also being extremely comfortable for the patient,” said Reznik, assistant professor of clinical ophthalmology at the Keck School. “Since it is a less invasive procedure than other traditional glaucoma surgical options, there are less side effects and the patients recover more quickly.”
Reznik added that USC Roski Eye Institute was proud to be the first in Los Angeles to implant the XEN device since Rohit Varma, MD, MPH, dean of the Keck School and director of the USC Roski Eye Institute, had worked with AqueSys Inc. to design the device and analyze the outcomes data over several years of clinical trials conducted in refractory glaucoma patients.
“The XEN device is a game changer for patients with primary open-angle glaucoma, pseudoexfoliative or pigmentary glaucoma with open angles that are unresponsive to maximum tolerated medical therapy,” Varma said. “In addition to offering a minimally invasive option for glaucoma patients that was successful in reducing eye pressure, our analysis also showed it helped reduce the study participant’s medications.”
Varma’s data analysis during clinical trials showed that one year after the implant, eye pressure was reduced by 44 percent from baseline and IOP medications, including eye drops, were reduced by 65 percent.
“It’s gratifying to see the XEN come full circle — we’re grateful to Dr. Varma, who was a valued adviser during several years of development and study of the device. Today, we celebrate the first patients in L.A. who received the XEN from glaucoma experts Dr. Reznik and Dr. Bedrood at USC,” said Roger Kash, director of professional education at Allergan Inc.
More than 3 million Americans have glaucoma, which is defined as a disease that damages the optic nerve of the eye. It most often occurs after age 40 and there is increased risk for glaucoma after age 60, but it can also be diagnosed in infants and children. Part of the difficulty in diagnosing glaucoma is there are few, if any, warning signs. Risk factors include increased age, family history and medical conditions such as diabetes, heart disease and high blood pressure. African Americans and Latinos have a higher risk of glaucoma than non-Hispanic whites.
“Glaucoma does not have to lead to blindness,” Varma said. “The disease progresses slowly, usually without any symptoms, so an annual dilated eye exam for early detection and treatment, especially after the age of 50, is essential to prevent blindness.”
— Sherri Snelling