Evaluation of Bleb Morphology and Reduction in IOP and Glaucoma Medication following Implantation of a Novel Gel Stent

Abstract EN

Objective.

To evaluate the efficacy and safety of the Xen Gel Stent and provide a macro- and microscopic analyses of bleb morphology.

Methods.

A prospective 12-month study on patients with primary open-angle glaucoma.

Patients underwent implantation of the XEN Gel Stent (Allergan INC, Dublin, Ireland) either alone or combined with a cataract surgery.

Biomicroscopy, in vivo confocal microscopy (IVCM), and anterior segment-optical coherence tomography (AS-OCT) were used to assess bleb morphology.

Safety parameters were adverse events, best corrected visual acuity, visual field, and corneal endothelial cell loss.

A postoperative IOP ≤ 18 mmHg without or on medications was respectively defined as complete and qualified success while an IOP ≥ 18 mmHg was defined as failure.

Results.

Twelve eyes of 11 patients were evaluated.

At one year, 5 out of 10 patients available achieved a complete success while five were qualified success.

AS-OCT showed that bleb wall reflectivity was significantly higher in the failure group; IVCM revealed that stromal density was significantly lower in the success group.

No safety issues were recorded.

Conclusion.

Implantation of the XEN Gel Stent appears to be a safe and effective procedure.

AS-OCT and IVCM may be helpful in bleb assessment.