GLAUCOMA 1, OPEN ANGLE, D (Disorder)
Conditions
Keywords
Glaucoma, MIBS, Minimally Invasive Bleb-Forming Surgery, Bleb-Forming Devices Without a Plate, Surgery, PRESERFLO, MicroShunt, XEN, Gelstent
Brief summary
The goal of this randomized controlled clinical trial is to learn whether two minimally invasive bleb-forming glaucoma implants can effectively treat adult patients with open-angle glaucoma who require surgical lowering of intraocular pressure (IOP). Specifically, the study evaluates whether the PRESERFLO™ MicroShunt is at least as effective as the XEN®-63 Gel Stent in reducing IOP after surgery.  The main questions it aims to answer are: * Does the PRESERFLO™ MicroShunt provide IOP reduction at 12 months that is non-inferior to the XEN®-63 Gel Stent? * How do the two devices compare over 24 months with respect to medication reduction, need for additional glaucoma procedures, complications, and preservation of visual function and ocular structures? Participants will: * Be randomly assigned (1:1) to receive either the XEN®-63 Gel Stent or the PRESERFLO™ MicroShunt during a single glaucoma surgery. * Attend scheduled follow-up visits over 24 months for eye-pressure measurements, vision testing, visual-field testing, OCT imaging, endothelial-cell counts, and safety assessments. * Receive standard postoperative care and report any complications or additional treatments during the study period.
Interventions
DEVICEXEN®-63 Gel Stent
The XEN®-63 Gel Stent is a hydrophilic gel implant made of cross-linked, purified collagen (gelatin). This devices bypasses the trabecular meshwork and lower eye pressure via a subconjunctival filtering bleb, aided by intra-operative mitomycin C to reduce scarring. It has already been approved for the European market and therefore bear the CE mark.
DEVICEPRESERFLO™ MicroShunt
The PRESERFLO™ MicroShunt is a SIBS-polymer microshunt. This devices bypasses the trabecular meshwork and lower eye pressure via a subconjunctival filtering bleb, aided by intra-operative mitomycin C to reduce scarring. It has already been approved for the European market and therefore bear the CE mark.
Sponsors
Universitaire Ziekenhuizen KU Leuven
University Hospital, Bonn
Hospital de Santa Maria, Lisbon
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
40 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* \>40 years of age * An established diagnosis of: Primary open angle glaucoma, Normal tension glaucoma, Pigment dispersion glaucoma (PDG) or Pseudoexfoliative glaucoma (PEX) * Inadequately controlled on maximum tolerated medical therapy. * Mean Deviation (MD) \</= -3 * Intraocular pressure of 14-28 mmHg * Endothelial Cell Count ≥1000 cells/mm2
Exclusion criteria
* An established diagnosis of: Closed-angle glaucoma or Secondary open-angle glaucoma (besides PDG and PEX) * Lens status: Aphakic patients or Anterior chamber intraocular lens * Previous procedures: Glaucoma shunt/valve/ surgery or cyclodestructive procedure, Selective laser trabeculoplasty within the past 3 months, Incisional ophthalmic surgery involving the conjunctiva within the past 3 months, Clear corneal cataract or trabecular meshwork surgery conducted within the past 6 months. * Presence of intraocular silicone oil * No light perception vision * Current corticosteroid use (ocular or oral) * Conjunctival pathologies (e.g., pterygium) * Active inflammation (e.g., blepharitis, conjunctivitis, keratitis, uveitis) * Vitreous present in the anterior chamber * Active iris neovascularization or neovascularization of the iris within 6 months of the surgical date * Unwillingness or inability to give consent, accept randomization or return for and participate in scheduled protocol visits
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Intraocular pressure | 1 year |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Number of medications | 2 year | Number of topical glaucoma medications |
| adverse events | 2 years | — |
| secundary pressure-lowering surgery | 2 years | — |
| Mean Deviation changes on the visual field | 2 years | — |
| Retinal Nerve Fibre Layer Thickness changes on Optical Coherence Tomography | 2 years | — |
| Endothelial Cell Count | 2 years | — |
| Best Corrected Visual Acuity | 2 years | — |
Countries
Belgium, Germany, Portugal
Contacts
CONTACTIngeborg Stalmans, MD, PhD
CONTACTThomas Jacobs, MD
Outcome results
None listed