Journal of Current Glaucoma Practice

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VOLUME 15 , ISSUE 2 ( May-August, 2021 ) > List of Articles


Outcomes of XEN Gel Stent Implantation in the Inferonasal Quadrant after Failed Trabeculectomy

Eyüp Düzgün, Ali Olgun, Murat Karapapak, Abdurrahman Alpaslan Alkan, Melih Ustaoğlu

Keywords : Inferonasal quadrant, Minimally invasive glaucoma surgery, Refractory glaucoma, Trabeculectomy, XEN gel stent

Citation Information : Düzgün E, Olgun A, Karapapak M, Alkan AA, Ustaoğlu M. Outcomes of XEN Gel Stent Implantation in the Inferonasal Quadrant after Failed Trabeculectomy. J Curr Glaucoma Pract 2021; 15 (2):64-69.

DOI: 10.5005/jp-journals-10078-1304

License: CC BY-NC 4.0

Published Online: 30-09-2021

Copyright Statement:  Copyright © 2021; Jaypee Brothers Medical Publishers (P) Ltd.


Aim and objective: To evaluate the efficacy and safety of XEN stent implantation in the inferonasal quadrant after prior failed trabeculectomy. Materials and methods: Fourteen open-angle glaucoma patients with prior failed trabeculectomy were recruited to this retrospective study. Implantation of the stent was performed as a stand-alone procedure. The mean follow-up duration was 14.2 months. Best-corrected visual acuity, intraocular pressure (IOP), number of medications, complications, and the requirement for additional procedures were among the outcome measures recorded. Results: Mean IOP reduced by 49.3% from 24.14 ± 2.74 mm Hg preoperatively to 12.23 ± 2.89 mm Hg at month 12 (p < 0.001). Medication usage reduced from 3.71 ± 0.47 medications preoperatively to 1.31 ± 1.55 at month 12 (p = 0.003). Adverse events included transient slight intracameral hemorrhage (5 eyes, 35.7%), second trabeculectomy required (2 eyes, 14.3%), and numerical hypotony (IOP <5 mm Hg, in 3 cases, 21.4%), all of which resolved spontaneously. Six eyes (42.8%) required postoperative bleb needling to further reduce IOP. There were no cases of vision loss, stent exposure, hypotony, lower eyelid malposition, bleb dysesthesia, or bleb-related infection. Conclusion: XEN gel stent implantation in the inferonasal quadrant can be considered a viable surgical option for patients with a history of previously failed trabeculectomy requiring further IOP lowering. Clinical significance: To the best of our knowledge, this is the first case series describing the outcome of inferonasal implantation of XEN gel stent following failed trabeculectomy.

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