ABSTRACT
INTRODUCTION: The XEN Gel Stent (AbbVie Pharmaceuticals) is a device made from Gelatin; a well-known material in the medical field that is firm enough to hold its shape and soft enough to conform to tissues and reduce the risk of erosion. The Gel Stent creates a permanent outflow connection between the anterior chamber and subconjunctival space. AREAS COVERED: Validation testing done on the Gel Stent to evaluate biocompatibility and durability of the material as well as real-world experience are included and discussed in this paper. EXPERT OPINION: Correlating the results of the preclinical testing, study outcomes available in the published literature, and the surgeons' experiences, the device and materials have shown to have an acceptable biocompatibility and durability profile, with a stable, nondegradable, and permanent implant.
Subject(s)
Glaucoma Drainage Implants , Glaucoma, Open-Angle , Anterior Chamber , Humans , Intraocular Pressure , StentsABSTRACT
El gran desarrollo de la cirugía de glaucoma mínimamente invasiva, conocida como MIGS, ha supuesto una alternativa eficaz en el tratamiento de esta enfermedad, y ha demostrado ser efectiva en la reducción de la presión intraocular. Presentamos a un paciente varón de 51 años con glaucoma en progresión, quien requería tratamiento médico máximo para el control de su enfermedad y en el que se realizó un triple procedimiento quirúrgico: cirugía de retirada de lente intraocular, facoemusificación e implante XEN®. La cirugía fue un éxito. Se consiguió el control tensional y se pudo prescindir completamente del uso de medicación hipotensora, lo que mejoró mucho la calidad de vida de nuestro paciente. La cirugía MIGS es una alternativa muy válida para el manejo del glaucoma. Cuenta con excelentes resultados, beneficios respecto a la cirugía clásica de glaucoma y un buen perfil de seguridad. En este caso clínico, presentamos el implante XEN® como una opción terapéutica útil en un paciente con glaucoma y valoramos sus indicaciones, beneficios y ventajas(AU)
Due to its great development, minimally invasive glaucoma surgery (MIGS) has become a useful alternative in the treatment of this condition, proving effective for intraocular pressure reduction. A case is presented of a male 51-year-old patient with glaucoma in progression who required maximum medical treatment to control his disease. The patient underwent a triple surgical procedure: intraocular lens removal surgery, phacoemulsification and XEN® implantation. The surgery was successful: pressure control was achieved and hypotensive medication was completely eliminated, with which the patient's quality of life improved considerably. MIGS is a very valid alternative in glaucoma management, due to its excellent results, benefits with respect to classic glaucoma surgery, and a good safety profile. The clinical case herein presented illustrates the use of XEN® implantation as a useful therapeutic option in a glaucoma patient, and reference is made to its indications, benefits and advantages(AU)
Subject(s)
Humans , Male , Middle Aged , Surgical Procedures, Operative/methods , Glaucoma/surgery , Phacoemulsification/methods , Quality of LifeABSTRACT
The XEN Gel Stent (Allergan Inc., an Abbvie company) is an implant that lowers intraocular pressure by creating a filtration pathway from the anterior chamber to the subconjunctival space, using the same pathway as trabeculectomy. While the primary method for implantation is via ab interno approach, it is also possible to implant the device ab externo. This technique paper details the surgical steps for closed conjunctival implantation of the Gel Stent and provides surgical pearls for enhancing outcomes.