Ab interno approach to the subconjunctival space using a collagen glaucoma stent

Area of Science:

• Ophthalmology
• Surgical Innovation
• Glaucoma Treatment

Background:

• Glaucoma filtration surgery aims to lower intraocular pressure (IOP) by creating artificial aqueous fluid drainage pathways.
• Traditional methods carry significant short- and long-term complications.
• Minimally invasive techniques are sought to improve safety and efficacy.

Purpose of the Study:

• To review the development and characteristics of a novel, soft, permanent ab interno collagen implant (XEN gel stent).
• To evaluate its potential for optimizing aqueous drainage in glaucoma surgery.
• To assess its safety and efficacy as a minimally invasive alternative.

Main Methods:

• Description of the XEN gel stent, focusing on critical design characteristics (lumen size, material, dimensions, flexibility, stability, biocompatibility).
• Review of preclinical and human eye testing data.
• Analysis of the ab interno surgical approach for stent placement.

Main Results:

• The XEN gel stent is designed to balance hypotony avoidance with maximal long-term outflow.
• Preclinical and human testing indicate no observed lumen occlusion.
• The implant material shows no apparent tissue reaction within the eye.

Conclusions:

• The ab interno XEN gel stent provides a minimally invasive approach to glaucoma surgery.
• It offers reduced conjunctival disruption and controlled flow to prevent hypotony.
• The implant demonstrates potential for long-term IOP reduction and safety.