Lamellar sclerectomy augmented XEN gel stent glaucoma surgery

Purpose To describe a surgical technique to optimize XEN gel stent position and its outflow. Methods A small 1- to 1.5-mm square lamellar sclerectomy was created at the external tip of the XEN gel stent implant. The lamellar scleral tissue, served as a patch graft, was secured at the gel stent insertion site. Results Four sequential, unselected, patients with failed primary XEN gel stent surgeries underwent bleb revisions with the technique described. These four patients achieved unmedicated intraocular pressures between 10 and 12 mmHg and a favourable bleb morphology despite repeated mitomycin C applications at 6 months. Conclusion Lamellar sclerectomy with auto-scleral graft augmented XEN gel stent surgery deliver successful short-term outcomes without major complications observed.