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To XEN or to phaco XEN?

Poster Details

First Author: M.Tsatsos UK

Co Author(s):    D. Gousia   U. Faridi                 

Abstract Details


To assess the effectiveness, viability and complications of the XEN device for the control of intraocular pressure and differentiate between the sole introduction of the XEN device and the combined Phacoemulsification and XEN surgery (Phaco XEN)


REI, Dorset County Hospital


15 Cases of XEN implantation and 15 patients that underwent combined Phacoemulsification and XEN implantation were studied for 12 months. The initial 10 cases after adopting the procedure were not included in the study to minimise the learning curve bias. 18 females and 12 males between the age of 64 to 87 were included in the study. Of the 15 XEN implantations 12 were pseudophakic and 3 Phakic. All patients followed the departmental trabeculectomy post-op regime of 2 hourly dexamethasone minims and weekly reviews.


Mean pre-operative IOP was 23 in the XEN and 24 in the Phaco-XEN groups. Post-op IOP was 12 in the XEN and 13 in the Phaco XEN groups. 8 Phaco XEN patients required needling as the they developed encapsulated blebs at the 4 week follow up, whereas 4 cases of sole XEN implantation underwent needling for encapsulation. 28 continue with diffuse blebs at 12 months follow up, one case was lost to follow up and 1 underwent a trabeculectomy to control the intraocular pressure.


XEN device implantation offers a useful alternative for the surgical treatment of high intraocular pressure without the need for conjuctival dissection. The procedure appears to be effective either as sole XEN implantation or as combined Phaco XEN with the need for significantly more post-op manipulation after the combined operations. The additional benefit compared to other implants of no conjuctival dissection, makes this mildly fiddly procedure an important adjuvant especially in patients that do not tolerate a long surgical procedure or suffer from poor ocular surface.

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