The XEN Gel Stent, often referred to as the XEN implant, is a small, flexible tube used in eye surgery. This tiny medical device is designed to create a new pathway for fluid drainage within the eye. The XEN implant is roughly 6 millimeters long and about as wide as a human hair, making it a discreet and effective treatment option.
Understanding Glaucoma and the XEN Implant’s Role
Glaucoma is a group of eye diseases that damage the optic nerve, which transmits visual information from the eye to the brain. This damage often relates to elevated pressure inside the eye, known as intraocular pressure (IOP). If left untreated, this high pressure can lead to irreversible vision loss and, in severe cases, blindness.
The eye continuously produces a fluid called aqueous humor, which normally drains through a mesh-like tissue called the trabecular meshwork. In glaucoma, this drainage system can become blocked or inefficient, causing fluid to build up and eye pressure to rise. The XEN implant offers a solution when medications or laser treatments are not enough to manage this pressure.
The XEN Gel Stent is indicated for managing refractory glaucomas when other treatments have failed. It provides an alternative to more invasive traditional surgeries like trabeculectomy for patients who need further IOP reduction.
How the XEN Implant Works and Surgical Process
The XEN implant functions by creating a new drainage pathway that bypasses the eye’s natural, often compromised, drainage system. It diverts aqueous humor from the anterior chamber, the front part of the eye, to the subconjunctival space, which is the area beneath the clear membrane covering the white part of the eye. This newly formed channel allows fluid to drain more freely, thereby lowering intraocular pressure.
The surgical procedure for implanting the XEN Gel Stent is minimally invasive and performed as an outpatient procedure. The eye is numbed with topical anesthesia, and an injector device, preloaded with the stent, is used. The surgeon inserts a needle through a small incision in the cornea, guiding it through the anterior chamber and into the subconjunctival space.
Once the needle is positioned, the gelatin stent is released. The stent, made of gelatin, hydrates and becomes flexible within minutes of contact with the aqueous humor, conforming to the surrounding tissue. This helps to secure the device and minimizes the risk of movement or erosion.
After the XEN Implant Procedure
Immediately following the XEN implant procedure, patients can return home, though arranging for transportation is advisable. Mild discomfort, such as soreness or the sensation of something in the eye, is common for the first 1-2 days and improves quickly. Blurry vision is also expected and can persist for several weeks, gradually improving.
Post-operative care involves adhering to specific instructions, including the use of prescribed eye drops, such as antibiotics. Glaucoma eye drops for the operated eye are discontinued. Regular follow-up appointments are scheduled to monitor eye pressure and the healing process.
During these follow-up visits, anti-scarring medications may be injected around the newly formed bleb to prevent scar tissue formation. While the procedure is well-tolerated, potential early side effects can include temporary low eye pressure or an increase in eye pressure requiring additional intervention. Avoiding rubbing or pressing on the implanted eye is advised to prevent damage to the stent.
Living with a XEN Implant: Long-Term Outlook
Living with a XEN implant involves ongoing monitoring to ensure eye pressure control. Regular follow-up appointments with an ophthalmologist are necessary to assess the implant’s function and overall eye health. The goal of the XEN implant is to achieve long-term reduction in intraocular pressure, which helps to slow or stop the progression of glaucoma and preserve vision.
Studies indicate that the XEN Gel Stent can provide a significant reduction in intraocular pressure over an extended period. Many patients experience a reduced reliance on eye drops, and some may even be able to discontinue them entirely.
While effective in lowering eye pressure, the XEN implant is a management tool for glaucoma, not a cure. Ongoing monitoring is important because the stent’s long-term success can vary depending on individual factors. Scar tissue formation around the stent can occur, potentially requiring additional procedures to maintain proper fluid drainage.