XEN Implant Fracture During Needling Procedure

Area of Science:

• Ophthalmology
• Surgical Devices

Background:

• The XEN implant is a hydrophilic stent used for glaucoma treatment.
• Postoperative needling is a common procedure for bleb-forming surgeries.

Observation:

• Three cases of XEN implant fracture occurred during the needling procedure in a series of 170 XEN implantations.
• The subconjunctival portion of the XEN implant fractured in these cases.
• The mean length of the fractured distal segment was 0.83 mm.

Findings:

• Despite XEN fracture in 3.1% of needling procedures, intraocular pressure (IOP) significantly decreased from a mean of 25.0 mmHg to 12.0 mmHg.
• No vision-threatening complications were observed during a mean follow-up of 15.3 months.
• Fracture of the XEN implant did not appear to compromise its efficacy in reducing IOP.

Implications:

• XEN implant fracture is a potential adverse event during bleb management that should be considered.
• The flexible material of the XEN implant makes it susceptible to needle damage.
• While fracture may not impair function, preserving implant integrity is recommended.