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    Gel stent brings new hope for early glaucoma patients

    Device as effective as trabeculectomy, can be used early with less surgical side effects


    Take-home message: The initial 36-month results are highlighted from a novel, soft and permanent, minimally invasive ab interno collagen implant used to optimize aqueous drainage to the subconjunctival space.



    Salzburg, Austria—A minimally invasive gel stent may bring new hope for patients with early glaucomas.

    Data from the largest trial to date of the device (XEN Gel Stent, AqueSys) for glaucoma support its safety and efficacy up to 3 years. The device showed a mean 40% reduction in IOP at 36 months and a 74% reduction in anti-glaucomatous medications. Pressure is drained directly from the anterior chamber into the subconjunctival space.


    “Because of the safety and efficacy, we can use this stent in relatively early glaucomas,” said lead author Herbert Reitsamer, MD, Lotte Schwarz Professor of Ophthalmology, Director of the Glaucoma Service, and director, Experimental Ophthalmology, at the SALK/Paracelsus Medical University, Salzburg, Austria.

    Did you know these 7 men were ophthalmologists?

    “We don’t have to wait until surgery is the last resort as we do with trabeculectomy,” Dr. Reitsamer said. “This stent is also a replacement for laser procedures or an increase in eye drops than it is a replacement for trabeculectomy.”

    The prospective, non-randomized, multicenter evaluation of multiple XEN models was conducted by more than 40 investigators in 13 countries. A total of 852 eyes were implanted using multiple stent models, protocols, and injectors. Of the total, 515 eyes were followed for 3 months, 224 eyes for 12 months, 70 eyes for 24 months, and 33 eyes for 36 months.

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    Most of the eyes (570) were treated with the most current device (XEN 45 Gel Stent). Overall outcomes were better for this more advanced device, which has been commercialized in Canada and Europe, including a mean drop in IOP of 48.8% at 24 months. But most of the XEN 45 eyes (334) were followed for 30 days. Only 287 eyes were followed for 3 months, 166 eyes for 6 months, 73 eyes for 12 months, and two eyes for 24 months. More complete data will be reported as more eyes move toward 3 years and longer follow up.

    Next: How stent performs

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