Ab-externo XEN gel stent implantation in primary open-angle glaucoma: 6-month follow-up

Abstract

Purpose: XEN gel stent (XGS) is one of the minimally invasive glaucoma surgery (MIGS) procedures offering substantial intraocular pressure (IOP)-lowering. We evaluated the efficacy and safety of XGS implantation via an ab externo approach in patients with primary open-angle glaucoma (POAG). We present 13 cases of successful XEN implantation via an ab externo approach in these patients.
Study design: Retrospective case series.
Methods: This was a retrospective case series involving patients diagnosed with POAG at a tertiary referral centre who underwent XGS implantation between February 2019 and June 2020 for uncontrolled IOP despite maximum topical medications. All patients underwent XGS implantation via an ab externo approach placed at the superotemporal quadrant. The main outcome measure was IOP reduction and number of antiglaucoma medications after XGS implantation, postoperative procedures, and surgical complications.
Results: Thirteen eyes of 13 patients were included in the analysis. At the 6-month follow-up, mean IOP reduction was 2.73 ± 3.66 mmHg and mean IOP was 13.8 ± 1.99 mmHg on an average of 1.6 antiglaucoma medications. Complications included transient hypotony and transient IOP spikes requiring needling. Two patients required stent removal due to recurrent conjunctival erosion and stent migration into the anterior chamber.
Conclusion: XGS implantation is able to achieve good IOP control with reduced need for antiglaucoma medications after a minimum follow-up of 6 months. Longer follow-up is needed to assess its long-term outcome.