XEN Surgery as a "Rescue" for Previous Glaucoma Drainage Device Surgery with Corneal Endothelial Cell Loss: A Case Report

XEN手术作为既往青光眼引流装置手术伴角膜内皮细胞丢失患者的“补救”方案:病例报告

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Abstract

AIM AND BACKGROUND: Glaucoma drainage device (GDD) implantation is effective for intraocular pressure (IOP) control but can lead to corneal endothelial cell loss due to tube positioning in the anterior chamber. This case report presents a novel surgical technique using a XEN stent as a "rescue" option for managing corneal endothelial cell loss after GDD surgery. CASE DESCRIPTION: A 38-year-old male with uveitic glaucoma underwent Ahmed glaucoma valve (AGV) implantation. Despite controlled IOP postoperatively, progressive corneal endothelial cell loss was observed over 2 years. Tube revision was performed by replacing the AGV tube with a XEN stent, which connected the anterior chamber to the existing AGV. Postoperatively, endothelial cell counts (ECCs) stabilized, and IOP remained well-controlled without complications. CONCLUSION: Replacing a GDD tube with a XEN stent is a promising alternative to prevent further corneal endothelial cell loss while maintaining IOP control. CLINICAL SIGNIFICANCE: This approach provides a novel surgical option for patients with progressive corneal endothelial cell loss after GDD surgery. HOW TO CITE THIS ARTICLE: Hwang YH, Kim M, Choi J. XEN Surgery as a "Rescue" for Previous Glaucoma Drainage Device Surgery with Corneal Endothelial Cell Loss: A Case Report. J Curr Glaucoma Pract 2025;19(2):97-99.

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