Official ESCRS | European Society of Cataract & Refractive Surgeons


Automated gonioscopy assessment of XEN45 gel stent angle location after isolated XEN or combined phaco–XEN procedures: clinical implications

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Session Details

Session Title: Glaucoma Management

Session Date/Time: Monday 16/09/2019 | 16:30-18:00

Paper Time: 17:30

Venue: Free Paper Forum: Podium 4

First Author: : R.Barão PORTUGAL

Co Author(s): :    P. José   F. Teixeira   N. Pinto Ferreira   P. Sens   L. Abegão Pinto                 

Abstract Details


To explore differences in XEN45 gel stent angle location between combined and isolated stent implantation. Secondary outcomes included intraocular pressure (IOP)-lowering efficacy and safety parameters, including intra-operative complications.


Centro Hospitalar e Universitário Lisboa Norte, Department of Ophthalmology, Glaucoma Section.


Cross-sectional study. Automated gonioscopy was performed in 24 eyes (19 patients) previously implanted with XEN45 without intra-operative gonioscopy. Of these, 8 had been isolated procedures, with the remaining 16 combined with cataract surgery. Clinical data was retrieved from patient file. Absolute success was defined as IOP decrease from baseline and in the 6mmHg


Automated gonioscopy was performed 14 ± 5.9 months after XEN implantation. Level of insertion of the XEN stent in the iridocorneal angle did not differ significantly, with most implants being placed at the spur level or anterior (isolated XEN, n=6, 75%; combined phaco-XEN, n=10, 62.5%). Absolute and qualified success was similar in both angle locations (anterior/scleral spur (SS), 31.25% and 68.75% vs. posterior to the SS, 37.5% and 75%, respectively). While overall safety outcome measures did not differ significantly between different XEN stents placements, the proportion of intra-operative hemorrhages was higher in the more posterior placements (p = 0.03).


Combining phacoemulsification with XEN45 implantation does not seem to influence stent location in the iridocorneal angle in a setting without intra-operative gonioscopy. Different anatomical location of XEN45 does not seem to significantly alter outcomes, although more posteriorly located stents may be associated higher intra-operative complications (such as bleeding).

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