Postoperative complications of Ab-Interno XEN implantation in primary angle closure glaucoma

The XEN Gel Stent offers a unique Ab-interno approach for managing glaucoma and has shown a favorable risk profile relative to traditional trabeculectomy. XEN implantation has almost exclusively been reported in patients with open angle glaucoma and data in patients with angle closure glaucoma is limited. We report a postoperative complication of the XEN Gel Stent in a patient with primary angle closure glaucoma. An 86-year-old man with primary angle closure glaucoma underwent combined phacoemulsification and XEN implantation. After approximately two months, intraocular pressure was elevated and the stent was occluded by iris pigmentary deposits, traversing from the proximal to the distal conjunctival ends of the stent. Using an Ab-interno approach, the implant was successfully explanted, and the patient's intraocular pressure was notably lowered.