Lamellar sclerectomy augmented XEN gel stent glaucoma surgery

Area of Science:

• Ophthalmology
• Glaucoma Surgery
• Surgical Innovation

Background:

• XEN gel stent implantation is a common procedure for glaucoma management.
• Optimizing stent position and outflow is crucial for surgical success.
• Failed primary XEN surgeries often require revision procedures.

Purpose of the Study:

• To describe a novel surgical technique to optimize XEN gel stent placement and enhance aqueous humor outflow.
• To present a method for improving outcomes in revision XEN gel stent surgeries.

Main Methods:

• A 1- to 1.5-mm square lamellar sclerectomy was performed at the external tip of the XEN gel stent.
• The created lamellar scleral tissue was utilized as a patch graft and secured at the stent insertion site.

Main Results:

• The technique was applied to four patients with failed primary XEN gel stent surgeries.
• All four patients achieved unmedicated intraocular pressures between 10 and 12 mmHg at 6 months.
• Favorable bleb morphology was observed despite prior mitomycin C applications.

Conclusions:

• Lamellar sclerectomy with an autologous scleral graft augmentation offers a promising approach for XEN gel stent surgery.
• This technique demonstrates successful short-term outcomes with no major complications in revision cases.