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Purpose <p>The XEN gel stent is a minimally invasive surgical device for patients with open-angle glaucoma, developed to reduce complications associated with traditional filtration surgery. This study aimed to identify clinical factors that influence long-term surgical success, particularly in the context of postoperative conjunctival scarring.</p> Methods <p>In this retrospective study, 773 eyes of patients with glaucoma treated at a tertiary care center underwent implantation of the XEN gel stent. The primary outcome was long-term surgical success, defined as a reduction in intraocular pressure of at least 20% and achieving a target pressure of 18, 15, or 12 mmHg, either without (complete) or with (qualified) medication. Secondary outcomes included intraocular pressure reduction, change in best-corrected visual acuity and medication use. Potential risk factors were analysed using Kaplan-Meier survival curves and multivariable Cox regression.</p> Results <p>At 24 months, complete and qualified success for a target pressure of 18 mmHg was achieved in 50% and 64% of cases, respectively; at 72 months, in 35% and 54%. Visual acuity remained stable. Female sex, mitomycin C dose, moderately elevated baseline pressure, and lower pressure on the first postoperative day were associated with significantly higher success rates (<i>p</i> &lt; 0.05). Glaucoma subtype and previous incisional glaucoma surgery had no significant effect.</p> Conclusion <p>Sex, lower antimetabolite dose and intraocular pressure values before and shortly after surgery are significant predictors of long-term success following XEN gel stent implantation.</p>

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Factors influencing the long-term-success of the XEN gel stent

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年1月13日

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  • Caroline J. Wenzel,
  • Daniel A. Wenzel,
  • Christina Pagonidou,
  • Vasyl Druchkiv,
  • Emil Nasyrov,
  • Bogomil Voykov

摘要

Purpose

The XEN gel stent is a minimally invasive surgical device for patients with open-angle glaucoma, developed to reduce complications associated with traditional filtration surgery. This study aimed to identify clinical factors that influence long-term surgical success, particularly in the context of postoperative conjunctival scarring.

Methods

In this retrospective study, 773 eyes of patients with glaucoma treated at a tertiary care center underwent implantation of the XEN gel stent. The primary outcome was long-term surgical success, defined as a reduction in intraocular pressure of at least 20% and achieving a target pressure of 18, 15, or 12 mmHg, either without (complete) or with (qualified) medication. Secondary outcomes included intraocular pressure reduction, change in best-corrected visual acuity and medication use. Potential risk factors were analysed using Kaplan-Meier survival curves and multivariable Cox regression.

Results

At 24 months, complete and qualified success for a target pressure of 18 mmHg was achieved in 50% and 64% of cases, respectively; at 72 months, in 35% and 54%. Visual acuity remained stable. Female sex, mitomycin C dose, moderately elevated baseline pressure, and lower pressure on the first postoperative day were associated with significantly higher success rates (p < 0.05). Glaucoma subtype and previous incisional glaucoma surgery had no significant effect.

Conclusion

Sex, lower antimetabolite dose and intraocular pressure values before and shortly after surgery are significant predictors of long-term success following XEN gel stent implantation.