title: Combined phacoemulsification and XEN45 surgery from a temporal approach and 2 incisions.
abstract: OBJECTIVE
  To assess the safety and effectiveness of phacoemulsification combined with XEN45 implant surgery in patients with cataract and open-angle glaucoma, with 12-month follow-up.
  
  
  METHODS
  A prospective study conducted on 30 eyes requiring phacoemulsification with, at least, 2 medications to control intraocular pressure (IOP). Phacoemulsification combined with XEN45 implant surgery was performed within 15minutes of administering subconjunctival mitomycin C. Surgery was performed through 2 temporal incisions, separated by 90°, using the inferior to enter the XEN45 and to implant it in the superior nasal region. A record was made of the best corrected visual acuity, IOP before and 1 day, 1 month, 3 months, 6 months, 9 months, and 12 months after surgery, the number of antiglaucomatous medications, and complications.
  
  
  RESULTS
  The best corrected visual acuity was 0.37±0.2 and 0.72±0.15 before and 12 months after surgery, respectively. The pre-operative IOP was 21.2±3.4mmHg, with 3.07 drugs, decreasing by 61.65% on the first day, 37.26% at 1 month, 35.05% at 3 months, 31% at 6 months, 30.6% at 9 months, and 29.34% at 12 months. The number of medications decreased by 94.57%. Complications occurred in 3 eyes, 2 of them were excluded because we could not complete the implantation (280° subconjunctival haemorrhage and XEN extrusion when trying to reposition). In a third case, the bleb was encapsulated at 5 months after surgery.
  
  
  CONCLUSIONS
  The phacoemulsification combined with XEN45 implant surgery can effectively reduce IOP and the number of drugs in mild-moderate open-angle glaucoma, as they rehabilitate the VA. The use of only 2 micro-invasive incisions makes it simple, quick and safe, with few complications at 12 months follow-up from surgery.
authors.affiliation: Servicio de Oftalmología, Hospital Clínico Universitario de Valencia, Valencia, España. Electronic address: vperezto@ono.com.
authors.forename: V T
authors.initials: VT
authors.lastname: Pérez-Torregrosa
authors.affiliation: Servicio de Oftalmología, Hospital Clínico Universitario de Valencia, Valencia, España.
authors.forename: Á
authors.initials: Á
authors.lastname: Olate-Pérez
authors.affiliation: Servicio de Oftalmología, Hospital Clínico Universitario de Valencia, Valencia, España.
authors.forename: M
authors.initials: M
authors.lastname: Cerdà-Ibáñez
authors.affiliation: Servicio de Oftalmología, Hospital Clínico Universitario de Valencia, Valencia, España.
authors.forename: A
authors.initials: A
authors.lastname: Gargallo-Benedicto
authors.affiliation: Servicio de Oftalmología, Hospital Clínico Universitario de Valencia, Valencia, España.
authors.forename: V
authors.initials: V
authors.lastname: Osorio-Alayo
authors.affiliation: Servicio de Oftalmología, Hospital Clínico Universitario de Valencia, Valencia, España.
authors.forename: A
authors.initials: A
authors.lastname: Barreiro-Rego
authors.affiliation: Servicio de Oftalmología, Hospital Clínico Universitario de Valencia, Valencia, España.
authors.forename: A
authors.initials: A
authors.lastname: Duch-Samper
mesh_terms: D002386:Cataract / Q000150:complications; D003094:Collagen; D003131:Combined Modality Therapy; D005782:Gels; D020327:Glaucoma Drainage Implants; D005902:Glaucoma, Open-Angle / Q000150:complications / Q000188:drug therapy / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D016685:Mitomycin / Q000627:therapeutic use; D009883:Ophthalmic Solutions / Q000627:therapeutic use; D018918:Phacoemulsification; D011446:Prospective Studies; D015607:Stents; D000072836:Surgical Wound; D014065:Tonometry, Ocular; D014792:Visual Acuity
chemical_list: D005782:Gels; D009883:Ophthalmic Solutions; D016685:Mitomycin; D003094:Collagen
keywords: Collagen; Colágeno; Glaucoma de ángulo abierto/cirugía; Glaucoma drainage implant; Implante de drenaje glaucoma; Intraocular pressure; Microcirugía; Microsurgery/methods; Open-angle glaucoma/surgery; Presión intraocular; Stents