{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T15:24:05Z","timestamp":1784042645221,"version":"3.55.0"},"reference-count":31,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2022,11,15]],"date-time":"2022-11-15T00:00:00Z","timestamp":1668470400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Best-corrected visual acuity often decreases temporarily or permanently after trabeculectomy (TE). The purpose of this study was to compare visual acuity and refractive changes after TE or XEN microstent implantation (XEN) in primary open-angle glaucoma (POAG) or pseudoexfoliation glaucoma (PEX) cases na\u00efve to prior glaucoma surgery over a 24-month follow-up period. We analyzed 149 consecutive glaucoma patients who received either TE or XEN because of medically uncontrollable POAG or PEX. Intraocular pressure (IOP), IOP-lowering medication use, subjective and objective refraction and best-corrected visual acuity were evaluated. In addition, surgically induced astigmatism (SIA) was calculated and compared using the vector analysis method described by Jaffe and Clayman. A total of 93 eyes (85 POAG; 8 PEX) were treated with TE and 56 eyes (50 POAG; 6 PEX) with XEN. After 24 months, the mean IOP and number of IOP-lowering medications used decreased significantly after TE (p &lt; 0.01) and XEN (p &lt; 0.01). In the TE group, mean best-corrected visual acuity (BCVA) changed from 0.16 \u00b1 0.26 to 0.23 \u00b1 0.28 logMAR (p &lt; 0.01) after 24 months, while mean BCVA did not change significantly in the XEN group (preoperative: 0.40 \u00b1 0.50 logMAR, postoperative: 0.36 \u00b1 0.49 logMAR; p = 0.28). SIA was almost the same in both groups at the end of the 24-month follow-up period (0.75 \u00b1 0.60 diopters after TE and 0.81 \u00b1 0.56 diopters after XEN; p = 0.57). In addition, there was no significant correlation between SIA and the observed BCVA changes or SIA and IOP reduction 12 or 24 months after TE or XEN. Our results demonstrate that TE and XEN are effective methods for reducing IOP and IOP-lowering medication use. The SIA was nearly similar in both groups. The SIA does not seem responsible for the decreased visual acuity after TE.<\/jats:p>","DOI":"10.3390\/life12111889","type":"journal-article","created":{"date-parts":[[2022,11,15]],"date-time":"2022-11-15T02:28:58Z","timestamp":1668479338000},"page":"1889","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Refractive Changes after Glaucoma Surgery\u2014A Comparison between Trabeculectomy and XEN Microstent Implantation"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2176-706X","authenticated-orcid":false,"given":"Caroline","family":"Bormann","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, University of Leipzig, Liebigstrasse 10-14, 04103 Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catharina","family":"Busch","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University of Leipzig, Liebigstrasse 10-14, 04103 Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matus","family":"Rehak","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University of Giessen, Friedrichstrasse 18, 35392 Giessen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuela","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University of Leipzig, Liebigstrasse 10-14, 04103 Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Scharenberg","sequence":"additional","affiliation":[{"name":"Augen\u00e4rzte am Kurpark, Soltauer Stra\u00dfe 6a, 21335 L\u00fcneburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Focke","family":"Ziemssen","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University of Leipzig, Liebigstrasse 10-14, 04103 Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan Darius","family":"Unterlauft","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University of Leipzig, Liebigstrasse 10-14, 04103 Leipzig, Germany"},{"name":"Department of Ophthalmology, Inselspital, University of Bern, Freiburgstrasse 4, 3010 Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,11,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1111\/j.1442-9071.1995.tb00135.x","article-title":"Ganglion cell death in glaucoma: Pathology recapitulates ontogeny","volume":"23","author":"Quigley","year":"1995","journal-title":"Aust. 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Lasers"}],"container-title":["Life"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-1729\/12\/11\/1889\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:18:15Z","timestamp":1760145495000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-1729\/12\/11\/1889"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,15]]},"references-count":31,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2022,11]]}},"alternative-id":["life12111889"],"URL":"https:\/\/doi.org\/10.3390\/life12111889","relation":{},"ISSN":["2075-1729"],"issn-type":[{"value":"2075-1729","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,11,15]]}}}