This study investigated the efficacy and safety of a cross-linked collagen stent (XEN 45) with or without cataract surgery in the treatment of glaucoma. Setting: Real-life setting. Design: Prospective, open-label, multicenter clinical trial. Methods: Eligible patients with glaucoma inadequately controlled by treatment, or poor compliance or intolerance to topical therapy were included. Patients were divided into those with implant only (solo group; phakic and pseudophakic patients) and implant combined with cataract surgery (combo group). Differences in average intraocular pressure (IOP) and number of medications between baseline and study end (12 months), and the rate of qualified and complete success were evaluated. Results: Overall, there were 115 patients in the solo group (43 phakic and 72 pseudophakic) and 56 in the combo group. Compared with baseline, mean IOP (23.