XEN® stent complications: a case series

• Published in: BMC ophthalmology Vol. 19; no. 1; p. 253
• Main Authors: Gupta, Chandni, Mathews, Divya
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 12.12.2019; BioMed Central; BMC
• Subjects: Aged; Aged, 80 and over; Alkylating Agents - administration & dosage; Anterior chamber; Anterior Eye Segment - pathology; Anterior Eye Segment - surgery; Aqueous Humor - physiology; Case Report; Case reports; Cataracts; Comparative analysis; Complications and side effects; Decision making; Eye surgery; Glaucoma; Glaucoma Drainage Implants - adverse effects; Glaucoma, Open-Angle - surgery; Humans; Hyaluronidase; Implants; Infection; Intraocular Pressure - physiology; Male; Middle Aged; MIGS; Mitomycin - administration & dosage; Ophthalmologic Surgical Procedures; Ophthalmology; Pressure; Prosthesis Implantation; Stents; Stents - adverse effects; Surgery; Tonometry, Ocular; XEN; Ireland; United States > US; Glaucoma; XEN; MIGS
• ISSN: 1471-2415; 1471-2415
• DOI: 10.1186/s12886-019-1267-y

XEN® gel stent (Allergan, Dublin/Republic of Ireland) is a relatively new microinvasive glaucoma device providing an ab-interno approach to the subconjunctival space for aqueous drainage and reduction of intraocular pressure. It is thought to be less invasive, reduce surgical time and post-operative infection rates compared with traditional glaucoma procedures. Little information however, has been published regarding complications and subsequent management. The authors highlight five complicated cases of XEN® stent insertion, how they were managed and key learning points. Cases include: entire stent found at the bottom of the anterior chamber several months after uncomplicated insertion, stent broke into multiple pieces during manipulation within subconjunctiva, XEN45 stent migrated into the anterior chamber 7 months post-operatively and a case of limbal-based conjunctival dissection during open revision which lead to additional scarring around the stent and subsequent raised intraocular pressure. We present some new and interesting complications of XEN implant as well as potential management options. This can assist clinical decision-making and enable better pre-operative discussions with patients regarding risks of surgery.