XEN®-63 Compared to XEN®-45 Gel Stents to Reduce Intraocular Pressure in Glaucoma

The XEN (R) gel stent reduces intraocular pressure (IOP) in glaucoma. XEN (R)-45 is widely used; the newer XEN (R)-63 has a larger lumen targeting potentially lower IOP outcomes. We retrospectively compared the first 15 XEN (R)-63 cases to 15 matched XEN (R)-45 controls. With a preoperative IOP of 18.1 +/- 3.9 mmHg (mean +/- SD) and a final IOP of 9.1 +/- 2.0 mmHg, XEN (R)-63 implantation resulted in an IOP reduction of 44.6 +/- 16.5%. Similarly, with a preoperative IOP of 18.3 +/- 4.5 mmHg and a final IOP of 10.3 +/- 2.1 mmHg, XEN (R)-45 implantation resulted in an IOP reduction of 40.1 +/- 17.2%. The median follow-up period was 204 days (range 78-338 days) for the XEN (R)-63 group and 386 days (range 99-1688 days) for the XEN (R)-45 group. In total, 5/15 eyes of each group underwent open conjunctival bleb revision within the period of observation. Three eyes of the XEN (R)-63 group had secondary glaucoma surgery. One eye in the XEN (R)-63 group and three eyes in the XEN (R)-45 group required a restart of antiglaucomatous medication. In conclusion, both stents effectively lower IOP and medication. XEN (R)-63 achieved a slightly lower IOP over a short follow-up. Complication and revision rates were similar.