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

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 ( < 0.001). Medication usage reduced from 3.71 ± 0.47 medications preoperatively to 1.31 ± 1.55 at month 12 ( = 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.

HOW TO CITE THIS ARTICLE

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