Scientific article

XEN 45 Gel Stent Implantation in Open Angle Glaucoma : 5-Year Results of a Prospective Study

Published inJournal of glaucoma, vol. 32, no. 11, p. 909-917
Publication date2023-11-04
First online date2023-09-04


XEN 45 Gel Stent is safe and effective for 3 years. The study results provide useful insight into the outcome of XEN 45 Gel Stent surgery over 5 years in daily clinical practice.


To evaluate 5-year outcomes of XEN 45 gel stent implantation (XEN) in patients with open angle glaucoma.


This is a prospective, single-center, interventional study. XEN implantation either alone (XEN) or combined with phacoemulsification (Phaco + XEN) was performed on 170 consecutive eyes (126 patients) with uncontrolled intraocular pressure (IOP) or disease progression despite medical treatment. “Complete” surgical success at 60 months was defined as unmedicated IOP ≤15 mm Hg and a relative IOP reduction ≥20% from medicated baseline, while “qualified” success allowed fewer ocular hypotensive medications than at baseline. Other definitions of success with various IOP targets were also analyzed. Secondary outcomes included mean IOP and IOP-lowering medication changes and rates of reoperations.


Mean age was 78.1±9.2 years, and 70.3% were female. Mean medicated IOP decreased from 19.8±7.7 mm Hg [19.6±7.1 (XEN) vs. 19.8±7.0 mm Hg (Phaco+XEN)] at baseline to 12.6±3.1 mm Hg [12.5± 3.1 (XEN) vs. 12.6±3.1 (Phaco+XEN)] at 5 years (−37.0%; P < 0.001). Medications decreased from 2.0±1.3 [2.0±1.3 (XEN) vs. 2.0±1.3 (Phaco+XEN)] to 0.8±1.1 [0.8±1.1 (XEN) vs. 0.8±1.1 (Phaco + XEN)] (−60%; P <0.001). Needling was performed in 84 eyes (49%), and 19.4% underwent a secondary surgical intervention. Complete success at 3 years was a strong predictor of success at 5 years (odds ratio: 3.06, P <0.01), while needling was associated with higher rates of failure (odds ratio: 3.6, P <0.01).


At 5 years, XEN gel stent implantation was a safe procedure and achieved clinically meaningful IOP and medication reduction. Success at 3 years is a predictor of success at 5 years. Needling correlates with higher failure rates.

  • Glaucoma
  • Microinvasive glaucoma surgery (MIGS
  • XEN 45 Gel Stent
  • Surgery
  • Open angle
  • Anterior segment
Affiliation Not a UNIGE publication
Citation (ISO format)
TORBEY, Julien et al. XEN 45 Gel Stent Implantation in Open Angle Glaucoma : 5-Year Results of a Prospective Study. In: Journal of glaucoma, 2023, vol. 32, n° 11, p. 909–917. doi: 10.1097/IJG.0000000000002302
Main files (1)
Article (Published version)
ISSN of the journal1057-0829

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