Glaucoma is a leading cause of blindness worldwide. Intraocular pressure (IOP) lowering is the only effective treatment strategy. Traditional glaucoma surgeries are generally considered to be unpredictable and associated with a high rate of complications. This has led to the development of a novel XEN Gel Implant, a type of minimally invasive glaucoma surgery (MIGS), lowering the IOP without extensive surgical dissection. Areas covered: A literature search was undertaken on PubMed using the terms XEN glaucoma, gelatin microstent, and MIGS. All the articles and case reports on XEN Gel Implant and selected articles on MIGS were studied and reviewed. We have discussed the results of most studies on XEN Gel Implant related to its efficacy, safety and success. Expert commentary: The XEN Gel Implant effectively lowers IOP and medication use, with a favorable safety profile. Long-term data on its success and cost-effectiveness are lacking. The studies have shown it to be without any serious adverse events and to have good safety profile encouraging future research on this novel implant. There is a need to correctly identify selection criteria for patients, who would benefit the most from the XEN Gel Implant.
Goniotomy with trabecular meshwork excision using the KDB could be an alternative surgery for severe or refractory glaucoma, significantly reducing IOP and medication use at 6 months, with a low rate of complications.
Minimally invasive glaucoma surgery includes different devices which provide a less invasive and safer means of reducing intraocular pressure. The XEN Gel Stent (Allergan Inc., CA) is an ab interno procedure which creates a subconjunctival drainage pathway. It is a new surgical device and there is a paucity of data on complications and their management. We report a clinical case of a leaking bleb after XEN surgery managed by bleb revision, conjunctival suturing, and XEN replacement.
Purpose: To describe the case and the follow-up of an inadvertently damaged XEN gel implant during needling procedure. Methods: Case report. Results: A 60-year-old African American patient underwent an uncomplicated combined phacoemulsification with the insertion of a XEN gel implant. Two months postoperatively, a needling procedure was required. During the needling procedure, a fragment of the XEN gel implant was inadvertently damaged. One month postoperatively, the intraocular pressure was still controlled and the bleb was functioning well. Conclusion: This case report reveals a previously unreported complication concerning XEN gel implant. It is important for the surgeon to pay attention during needling procedure, especially if there is a subconjunctival hemorrhage impairing the view, to defer the procedure until good visibility exists.
ODR is a rare complication of filtering surgery. To the best of our knowledge, this is the second reported case of ODR occurring after deep sclerectomy and first description using OCTA. OCTA showed superficial and deep retinal hemorrhages with a normal vascular configuration. High-preoperative IOP seems to be the most important risk factor for this complication.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.