XEN(®)-63 Compared to XEN(®)-45 Gel Stents to Reduce Intraocular Pressure in Glaucoma

The XEN(®) gel stent reduces intraocular pressure (IOP) in glaucoma. XEN(®)-45 is widely used; the newer XEN(®)-63 has a larger lumen targeting potentially lower IOP outcomes. We retrospectively compared the first 15 XEN(®)-63 cases to 15 matched XEN(®)-45 controls. With a preoperative IOP of 18.1 ± 3.9 mmHg (mean ± SD) and a final IOP of 9.1 ± 2.0 mmHg, XEN(®)-63 implantation resulted in an IOP reduction of 44.6 ± 16.5%. Similarly, with a preoperative IOP of 18.3 ± 4.5 mmHg and a final IOP of 10.3 ± 2.1 mmHg, XEN(®)-45 implantation resulted in an IOP reduction of 40.1 ± 17.2%. The median follow-up period was 204 days (range 78–338 days) for the XEN(®)-63 group and 386 days (range 99–1688 days) for the XEN(®)-45 group. In total, 5/15 eyes of each group underwent open conjunctival bleb revision within the period of observation. Three eyes of the XEN(®)-63 group had secondary glaucoma surgery. One eye in the XEN(®)-63 group and three eyes in the XEN(®)-45 group required a restart of antiglaucomatous medication. In conclusion, both stents effectively lower IOP and medication. XEN(®)-63 achieved a slightly lower IOP over a short follow-up. Complication and revision rates were similar.