Abstract
AIM AND BACKGROUND: The XEN Gel Implant is a microstent, which aims to lower intraocular pressure by forming a subconjunctival bleb to drain aqueous. The aim of this study is to assess the IOP-lowering effects of a novel trimming surgical technique, which shortens the length of the XEN Gel Stent. MATERIALS AND METHODS: Patients who underwent placement of an XEN Gel Stent using the novel primary trimming technique from 10/2020 to 6/2023 were included for chart review. The technique includes an intentional trimming of the XEN about 1 mm prior to ab interno placement. Outcomes included intraocular pressure (preoperative, postoperative month 1, postoperative month 6, postoperative year 1) as well as the number of glaucoma drops. Statistical analysis was performed to assess for differences between preoperative and postoperative outcomes. RESULTS: Thirty cases were included. The average age of patients was 73.3 ± 11.7 years. The average preoperative IOP was 19.9 ± 5.8 mm Hg. The average number of preoperative glaucoma drops was 2.6 ± 1.2. The average IOP at postoperative month 1 (14.0 ± 5.7 mm Hg), postoperative month 6 (13.8 ± 7.6 mm Hg), and postoperative year 1 (13.3 ± 8.0 mm Hg) were all significantly lower than preoperative IOP (p < 0.01). The average number of glaucoma drops at year 1 was 1.5 ± 1.2 and significantly lower than the number of preoperative glaucoma drops (p < 0.01). Postoperative complications included in-office bleb needling (33.3%), IOP spike (20%), hypotony (10%), and cystoid macular edema (3.3%). No cases had conjunctival erosion. CONCLUSION: This surgical trimming technique for the XEN Gel Stent showed significant reductions in IOP at postoperative month 1, month 6, and year 1, as well as the need for fewer postoperative glaucoma drops for adequate control. CLINICAL SIGNIFICANCE: This novel technique effectively lowers IOP among patients with a low IOP goal while maintaining a safety profile comparable to standard methods. HOW TO CITE THIS ARTICLE: Atta S, Li A. Intraocular Pressure and Medication Outcomes of a Novel Primary Trimming Technique for XEN Gel Stent. J Curr Glaucoma Pract 2025;19(3):125-128.