XEN Gel stent: A Review

Abstract

Over the last decade, several new surgical devices and treatment options have been developed for the management of glaucoma. Together, known as micro-invasive glaucoma surgery, they aim to provide a safer approach to glaucoma surgery. Although the early devices were used to either stent or ablate a segment of the trabecular meshwork, newer devices such as the XEN gel stent (Allergan Inc., Dublin, Ireland), offer the possibility of creating a safer, more predictable filtering bleb. Since its FDA approval in 2016, several retrospective case series and prospective studies have highlighted the efficacy of the XEN gel stent with regards IOP lowering and reduction in the need for glaucoma medications. The XEN gel stent has also been shown to have a favorable safety profile in terms of intraoperative and post-operative complications. The major concern is the need for bleb intervention in the form of needling and injection of anti-fibrotic agents. This review focuses to summarize the current knowledge on the XEN gel stent for treatment of various subtypes of glaucoma.

Comparison of Clinical Outcomes Following Gel Stent Implantation via Ab-Externo and Ab-Interno Approaches in Patients with Refractory Glaucoma

“… 14 The gel stent was designed to allow controlled passage of aqueous humor, effectively decrease IOP and potentially prevent hypotony in eyes with refractory glaucoma. 15–17 The device creates a permanent channel through the sclera, allowing the flow of aqueous humor from the anterior chamber into the subconjunctival space. 18 The studies that led to approval of this device relied on an ab interno approach through a small corneal incision 19 and, while there are some reports of surgeons using ab externo techniques, 20–23 larger studies are needed.…”