[Review of surgical techniques for XEN Gel Stent implantation in glaucoma surgery]

Glaucoma is a common, chronic, progressive optic neuropathy which can lead to permanent blindness. The main risk factor accessible to treatment is elevated intraocular pressure. Conventional glaucoma surgery carries risks, including hypotony, infection and irreversible visual loss. Minimally invasive glaucoma surgeries (MIGS or LIGS) have been developed to limit these risks, among which is XEN.

To characterize the various XEN implantation techniques.

We performed a literature review and a retrospective single-center study to identify XEN surgical implantation techniques. We studied intraocular pressure, surgical videos and imaging (OCT-SA, etc.) postoperatively.

Five implantation techniques are described for XEN: ab interno with closed conjunctiva, ab interno with conjunctival opening, ab externo with closed conjunctiva, ab externo with conjunctival opening, and ab interno with injection of viscoelastic and air. The ab interno approach with closed conjunctiva is the most frequently used. The ab externo approach with open conjunctiva may be useful in complex cases.

The choice of surgical technique depends on the surgeon's preference, the complexity of the case, and other factors. The XEN is an effective minimally invasive device for the treatment of glaucoma.