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Review
. 2018 Apr 30:12:773-782.
doi: 10.2147/OPTH.S146919. eCollection 2018.

XEN glaucoma treatment system in the management of refractory glaucomas: a short review on trial data and potential role in clinical practice

A De Gregorio  1 , E Pedrotti  2 , G Stevan  1 , A Bertoncello  1 , S Morselli  1
Affiliations
Review

XEN glaucoma treatment system in the management of refractory glaucomas: a short review on trial data and potential role in clinical practice

A De Gregorio et al. Clin Ophthalmol. .

Abstract

The recent development of new devices that are significantly less invasive, collectively termed minimally invasive glaucoma surgery, offers new perspective of intraocular pressure reduction with less risk, short operating times, and rapid recovery. The aim of this work is to provide a panoramic review of the currently published clinical data to assess the potential role of XEN gel stent (Allergan PLC, Irvine, CA, USA) in the management of glaucoma, which is the only filtering minimally invasive glaucoma surgery device that allows the subconjunctival filtration. The ab interno placement of the XEN gel stent offers an alternative for lowering intraocular pressure in refractory glaucoma as a final step, and in patients intolerant to medical therapy as an early surgical approach with minimum conjunctival tissue disruption, restricted flow to avoid hypotony, and long-term safety.

Keywords: gel stent; glaucoma; minimally invasive; subconjunctival drainage; surgery.

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Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
(A) XEN gel stent; (B) preloaded injector and correct handling.
Figure 2
Figure 2
(A) MMC subconjunctival injection; (B) massage; (C) hydroexpansion. Abbreviation: MMC, mitomycin C.
Figure 3
Figure 3
Sequence of XEN45 gel stent implant (A–D).
Figure 4
Figure 4
Correct implantation of XEN45 gel stent (2.0 mm of exposed implant in the subconjunctival space, 1.0 mm in the anterior chamber, and 3.0 mm tunneled through sclera).
Figure 5
Figure 5
XEN45 gel stent dislocation in the anterior chamber.
Figure 6
Figure 6
Lower-lying filtering bleb in XEN45 gel implant at 6 months.
Figure 7
Figure 7
(A) Hypertrophic XEN45 bleb; (B) after inferior bleb needling.
Figure 8
Figure 8
(A and B) AS-OCT analysis of XEN45 bleb at 6 months. Abbreviation: AS-OCT, anterior segment-optical coherence tomography.
See this image and copyright information in PMC

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