Short-term Efficacy and Safety of XEN Stent Implantation with or without a Conjunctival Incision

Purpose: Comparison of the 6-month outcomes of ab externo XEN 45 gel stent implantation with conjunctival resection in Korean glaucoma patients.Methods: From January to May 2021, 43 open-angle glaucoma patients who underwent ab externo XEN stent insertion alone and were followed for more than 6 months were classified into incision (n = 23) and non-incision (n = 20) groups according to the presence or absence of a conjunctival incision and analyzed retrospectively. Qualified or complete success was defined as achieving the personal target intraocular pressure (IOP) with or without medication, respectively.Results: The IOP measured 6 months after surgery decreased significantly in both groups. The number of IOP-lowering drugs required was also reduced. The decrease in IOP after surgery was greater in the non-incision group. Six months after surgery, the qualified success rate was 55% in the non-incision group and 52.2% in the incision group, while the complete success rate was 40% and 8.7%, respectively. During follow-up, 58.1% of the patients underwent bleb needling more than once, and 20.9% underwent additional IOP-lowering surgery, but there was no difference between the two groups.Conclusions: XEN stent insertion helped to reduce IOP and the number of IOP-lowering agents after 6 months regardless of a conjunctival incision. However, to maintain the target IOP, bleb manipulation was required in many cases.