Evaluation of Bleb Morphology and Reduction in IOP and Glaucoma Medication following Implantation of a Novel Gel Stent

Objective. to evaluate the efficacy and safety of the xen gel stent and provide a macro- and microscopic analyses of bleb morphology. methods. a prospective 12-month study on patients with primary open-angle glaucoma. patients underwent implantation of the xen gel stent (allergan inc,dublin,ireland) either alone or combined with a cataract surgery. biomicroscopy,in vivo confocal microscopy (ivcm),and anterior segment-optical coherence tomography (as-oct) were used to assess bleb morphology. safety parameters were adverse events,best corrected visual acuity,visual field,and corneal endothelial cell loss. a postoperative iop ≤ 18 mmhg without or on medications was respectively defined as complete and qualified success while an iop ≥ 18 mmhg was defined as failure. results. twelve eyes of 11 patients were evaluated. at one year,5 out of 10 patients available achieved a complete success while five were qualified success. as-oct showed that bleb wall reflectivity was significantly higher in the failure group; ivcm revealed that stromal density was significantly lower in the success group. no safety issues were recorded. conclusion. implantation of the xen gel stent appears to be a safe and effective procedure. as-oct and ivcm may be helpful in bleb assessment. © 2017 antonio maria fea et al.