"Intrableb pigmentation following XEN implantation: A case series"

Area of Science:

• Ophthalmology
• Glaucoma Surgery
• Medical Devices

Background:

• Uncontrolled intraocular pressure (IOP) poses a significant risk for glaucoma patients.
• Minimally invasive glaucoma surgery (MIGS) with devices like the XEN-gel stent offers an alternative for IOP management.
• Complications following MIGS require thorough investigation to ensure patient safety and surgical efficacy.

Purpose of the Study:

• To determine the incidence of intra-bleb pigmentation (IBP) after XEN-gel stent implantation.
• To characterize the different patterns and clinical presentations of IBP.
• To assess the impact of IBP on bleb function and IOP control.

Main Methods:

• A retrospective case series design was employed.
• Data from three eyes with IBP post-XEN implantation were analyzed.
• Slit lamp biomicroscopy, anterior segment optical coherence tomography (AS-OCT), and IOP measurements were utilized.

Main Results:

• Three of 40 patients (7.5%) developed IBP within 12 months post-surgery.
• IBP manifested as diffuse or punctiform patterns.
• Punctiform IBP was associated with XEN ostium obstruction and reduced bleb function; diffuse IBP occurred post-needling in one case.
• All patients maintained IOP below 21 mmHg at follow-up.

Conclusions:

• Intra-bleb pigmentation is a potential complication of XEN-gel stent surgery.
• The pattern of IBP may indicate the status of bleb filtration and function.
• Regular follow-up including slit lamp, IOP checks, and AS-OCT is recommended for early detection and management of IBP.