XEN gel implant: how to make it more efficient

Session Details

Session Title: Presented Poster Session: Glaucoma

Venue: Poster Village: Pod 2

First Author: : S.Stunf Pukl SLOVENIA

Co Author(s): :                           

Abstract Details

Purpose:

to present the revision technique for failed Xen gel implants.

Setting:

University Eye Hospital Ljubljana

Methods:

Five patients (5 eyes) with failed Xen gel implant, flat filtering bleb and bent subconjunctival portion of Xen gel implant underwent surgical revision of the implant. The surgical technique for revision, pre and postoperative intraocular pressure and filtering bleb outlook are presented.

Results:

Mean patients' age was 66.4 years, average preoperative IOP was 22.8 mmHg. There were 4 standalone Xens and 1 combined, all with subconjunctival mitomicin 0.1mg/ml. Mean postoperative IOL one at 3 months was 19.4 mmHg with flat filtering blebs and bent Xen subconjunctivally. The revision was performed, conjunctiva opened at the limbus, the Xen in fibrous sock exposed, expressed out of the fibrosis, repositioned into the subtenon space and accidentally shortened in three patients. Postoperatively in all but one a diffuse filtering bleb formed with intraocular pressure 10-15 mmHg, lower in patients with accidentally shortened implant.

Conclusions:

Minimal invasive glaucoma surgery with Xen gel implant is a convenient surgical approach for primary open angle glaucoma but has the limitations of filtering bleb fibrosis and cannot reach a very low target pressure. With our approach of revision of failed Xen gel implants both of these limitations were overcame, lower target pressure by chance discovered with accidentally shortened subtenon portion of the implant.

Financial Disclosure:

None