Complication of micro-bypass stenting: the anterior chamber displacement
                        of a Xen implant

Atalay, Kursat; Nacaroğlu, Şenay Aşık; Kirgiz, Ahmet

doi:10.5935/0004-2749.20180098

Cited by 4 publications

(4 citation statements)

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“…9 This is somewhat similar to one case of complete XEN dislocation which occurred after attempted manipulation of the XEN. 10 Unlike these cases where there was movement of the XEN after a secondary procedure, the XEN in our case migrated after seemingly uncomplicated surgery and did not cause a rise in intraocular pressure.…”

Section: Resultscontrasting

confidence: 52%

Migration of XEN45 Implant: Findings, Mechanism, and Management

Ali

Di²,

Stringa³

et al. 2019

Journal of Current Glaucoma Practice

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AimThe aim of this study is to report the mechanism of XEN migration and its management.BackgroundOver the past decade, new less invasive surgical approaches for glaucoma have been devised and carried out successfully. One such technique is the use of the XEN gel stent. We present a rare and relatively unknown complication of XEN migration and present in detail the likely mechanism by which this occurs, and its subsequent management.Case descriptionA 73-year-old male with primary angle closure on maximal medical treatment presented with an intraocular pressure of 30 mm Hg in the left eye. The visual acuity was 6/5, iridocorneal angles were open in all four quadrants, and the cup disc ratio was 0.4. As phacoemulsification alone was unlikely to adequately lower intraocular pressures, the patient underwent combined phacoemulsification and XEN implantation. Although the patient had a good postoperative result with pressures lowered to 11 mm Hg, 4 months after the operation, the XEN was found to have migrated 4 mm into the anterior chamber, associated with a low-grade uveitis. The patient subsequently had the XEN explanted a new XEN inserted. Pressures lowered 1 month postoperatively to 14 mm Hg.ConclusionXEN migration is likely due to a combination of mechanical and frictional forces. If the XEN is positioned such that more than 2 mm is in the subconjunctival space, the XEN is likely to be angled upward and, therefore, be more susceptible to these forces and undergo migration.Clinical significanceIt is essential that XEN implants are correctly sited and that this is confirmed intraoperatively to prevent the need for further procedures.How to cite this articleAli ZC, Khoo DI, et al. Migration of XEN45 Implant: Findings, Mechanism, and Management. J Curr Glaucoma Pract 2019;13(2):79–81.

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Section: Resultscontrasting

confidence: 52%

Migration of XEN45 Implant: Findings, Mechanism, and Management

Ali

Di²,

Stringa³

et al. 2019

Journal of Current Glaucoma Practice

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“…4 A further case of complete XEN implant dislocation after attempted manipulation of a dysfunctional, bent implant has been reported. 5 It is unclear as to why the XEN implant in our case migrated into the anterior chamber. In the case reports discussed, factors such as episcleritis and possible incorrect surgical placement were discussed.…”

Section: Discussionmentioning

confidence: 81%

“…Topical treatment was restarted to control the IOP and the patient underwent phacoemulsification and removal of XEN implant from the anterior chamber 4. A further case of complete XEN implant dislocation after attempted manipulation of a dysfunctional, bent implant has been reported 5…”

Section: Discussionmentioning

confidence: 99%

Migration of the XEN45 Gel Stent into the Anterior Chamber Managed by Trimming the Implant

Sigona

Murthy

2021

Journal of Glaucoma

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“…• Be aware of high-risk patients. Reported risk factors are similar to those for persistent hypotony following trabeculectomy, including young age and high myopia [47,48]. Also, patients who previously underwent a cyclodestructive procedure and thus have low aqueous humor production, may be at higher risk.…”

Section: Preventionmentioning

confidence: 85%

Navigating Challenges after Xen

Vera¹,

Shah

Smith

et al. 2021

CTOY

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The XEN Gel Stent is a surgical implant for the treatment of glaucoma unresponsive to maximum tolerated medical therapy, with higher predictability and fewer sight-threatening complications than trabeculectomy or tube shunts. While complications following XEN implantation may be less common than in other glaucoma procedures, they are not completely avoidable. This paper elaborates the most commonly reported complications following XEN implantation with an aim to mitigate their occurrence by understanding the pathophysiology behind them. In addition, the authors provide insights from the literature and their own experience and make recommendations for management when complications do occur.

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Complication of micro-bypass stenting: the anterior chamber displacement of a Xen implant

Cited by 4 publications

References 0 publications

Migration of XEN45 Implant: Findings, Mechanism, and Management

Migration of XEN45 Implant: Findings, Mechanism, and Management

Migration of the XEN45 Gel Stent into the Anterior Chamber Managed by Trimming the Implant

Navigating Challenges after Xen

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