Vol. 4 No. 1 (2021): Current Issue
Review Article

Navigating Challenges after Xen

Vera V
Department of Glaucoma, Unidad Oftalmologica de Caracas, Caracas, Venezuela
Shah M
Kellogg Eye Center, University of Michigan, United States
Smith T
Glaucoma Associates of Texas, United States
Pinto LA
Faculty of Medicine of Lisbon University, Portugal
Reitsamer H
University of Salzburg, Austria

Published 2021-03-17


  • Glaucoma,
  • Glaucoma filtering surgery,
  • Glaucoma gel stent,
  • Bleb revision,
  • Hypotony


The XEN Gel Stent is a surgical implant for the treatment of glaucoma unresponsive to maximum tolerated medical therapy, with higher predictability and fewer sight-threatening complications than trabeculectomy or tube shunts. While complications following XEN implantation may be less common than in other glaucoma procedures, they are not completely avoidable. This paper elaborates the most commonly reported complications following XEN implantation with an aim to mitigate their occurrence by understanding the pathophysiology behind them. In addition, the authors provide insights from the literature and their own experience and make recommendations for management when complications do occur.