XEN Glaucoma is a surgical intervention designed to manage intraocular pressure in individuals with glaucoma. This treatment utilizes the XEN Gel Stent, a tiny, flexible device. The stent is implanted to provide a minimally invasive option for reducing eye pressure. Its primary aim is to offer an alternative when other methods of pressure control are insufficient.
How the XEN Gel Stent Lowers Eye Pressure
The XEN Gel Stent works by creating a new pathway for the aqueous humor, the fluid inside the eye, to drain. Normally, this fluid exits the eye through a natural drainage system, but in glaucoma, this system can become blocked or less efficient. The stent bypasses the diseased natural outflow system.
Once implanted, the stent channels the aqueous humor from the anterior chamber of the eye to the subconjunctival space, an area just beneath the conjunctiva, the clear membrane covering the white part of the eye. This re-routing of fluid leads to the formation of a small, raised area called a “bleb” on the surface of the eye, usually under the upper eyelid. The fluid collected in this bleb is then reabsorbed by the surrounding tissues and blood vessels, effectively lowering the intraocular pressure. This mechanism helps protect the optic nerve from damage and preserve vision.
Who Benefits from XEN Glaucoma Treatment
The XEN Gel Stent is typically considered for patients with certain types of glaucoma, including primary open-angle, pseudoexfoliative, or pigmentary glaucoma. It is indicated for individuals whose intraocular pressure is not adequately controlled despite maximal medical therapy, such as eye drops. The stent can also be an option for patients who have previously undergone other unsuccessful glaucoma surgeries.
Doctors may recommend the XEN Gel Stent over more traditional glaucoma surgeries due to its minimally invasive nature. This approach generally involves less tissue disruption and a potentially faster recovery compared to procedures like trabeculectomy. The XEN Gel Stent can be performed as a standalone procedure or in conjunction with cataract surgery, offering flexibility in treatment planning. However, it is not suitable for all glaucoma types, such as angle-closure glaucoma where the angle has not been surgically opened, or in cases with significant conjunctival scarring or active eye inflammation.
What to Expect During the XEN Procedure
The XEN Gel Stent implantation is a minimally invasive procedure performed in an outpatient surgical center. Patients usually receive local or topical anesthesia to ensure comfort during the procedure. The surgery itself is relatively short, often taking between 15 to 30 minutes.
During the procedure, a small incision is made on the surface of the eye, often in the clear front window of the eye. The XEN Gel Stent is then carefully inserted through this opening. The surgeon guides the stent to create the new drainage pathway from the anterior chamber to the subconjunctival space. Once the stent is in its precise location, the injector is removed, and the small incision typically seals itself without the need for stitches.
Life After XEN Surgery
Following XEN Gel Stent surgery, patients can generally expect a quick recovery, with many returning to their normal routines within a week or less. Immediate post-operative instructions include the use of prescribed eye drops, often consisting of steroids and antibiotics, to help manage inflammation and prevent infection. Patients are usually advised to avoid strenuous activities, heavy lifting, or any actions that might increase pressure in the eye for a few days to a week.
Blurred vision, mild discomfort, and light sensitivity are common temporary side effects in the initial weeks after surgery, gradually improving as the eye heals. Regular follow-up appointments are important to monitor eye pressure, assess the bleb’s function, and adjust eye drop regimens as needed. In some cases, a procedure called “needling” may be performed during follow-up visits to release scar tissue that might be impeding the stent’s drainage. While the XEN Gel Stent is designed to stay in the eye permanently to help maintain lower eye pressure, it does not cure glaucoma, and ongoing monitoring and management of the condition remain necessary.