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Since this population has low expected success rates with additional surgery, it is vital to compare to standard-of-care surgical options.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Retrospective, single-center, case\u2013control study of <jats:italic>ab externo<\/jats:italic> transconjunctival Xen shunt in eyes that have previously undergone trabeculectomy and\/or GDD surgery. Postoperative data were collected for 18\u00a0months. Failure was defined as no light perception, additional glaucoma surgery required, or intraocular pressure (IOP) of\u2009&lt;\u20096\u00a0mmHg after 6\u00a0weeks postoperatively.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Eighteen Xen eyes and 36 control eyes matched on both glaucoma type and previous glaucoma surgeries were included. Seventy-two percent had primary open angle glaucoma, 11% uveitic, 6% primary angle closure, 6% pseudoexfoliation, and 6% pigmentary glaucoma. Fifty-six percent of eyes in each group had prior trabeculectomy, 28% of Xen and 31% of control eyes had prior GDD, and 17% of Xen and 14% of control eyes had both. Baseline medicated IOP was lower in the Xen group (21.8\u2009\u00b1\u20097.2) compared to controls (27.5\u2009\u00b1\u20099.4, <jats:italic>P<\/jats:italic>\u2009=\u20090.043). The cumulative failure rate at year 1 was 17% for Xen and 20% for controls (<jats:italic>P<\/jats:italic>\u2009=\u20090.57). Mean survival time was 14.1 (\u00b1\u20091.5) months and 11.4 (\u00b1\u20090.6) months for controls. There was no difference in minor complication rates between groups (<jats:italic>P<\/jats:italic>\u2009=\u20090.65), but the Xen group had a significantly lower rate of serious complications (<jats:italic>P<\/jats:italic>\u2009=\u20090.043) defined as vision threatening or requiring surgical intervention in the operating room. When censored for additional glaucoma procedures, there were no differences at year 1 in IOP, change in IOP, number of IOP-lowering medications, or number of medications reduced from baseline.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>The Xen shunt provides a reasonable alternative to current standard of care, with a similar failure rate at year 1, with a noninferior IOP reduction compared to GDD and CPC, and a preferred safety profile.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00417-022-05857-6","type":"journal-article","created":{"date-parts":[[2022,10,22]],"date-time":"2022-10-22T08:02:46Z","timestamp":1666425766000},"page":"779-789","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Defining the role of ab externo Xen gel stent in glaucomatous eyes with prior failed surgical intervention"],"prefix":"10.1007","volume":"261","author":[{"given":"Lillian K.","family":"To","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rupak K.","family":"Dhoot","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alice Z.","family":"Chuang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sam","family":"Karimaghaei","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francisco","family":"Guevara-Abadia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruchi D.","family":"Shah","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1695-4322","authenticated-orcid":false,"given":"Robert M.","family":"Feldman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,10,22]]},"reference":[{"issue":"11","key":"5857_CR1","doi-asserted-by":"publisher","first-page":"2081","DOI":"10.1016\/j.ophtha.2014.05.013","volume":"121","author":"YC Tham","year":"2014","unstructured":"Tham YC, Li X, Wong TY, Quigley HA, Aung T, Cheng CY (2014) Global prevalence of glaucoma and projections of glaucoma burden through 2040: a systematic review and meta-analysis. 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All research adhered to the Declaration of Helsinki and was HIPAA compliant, and data collection conformed with all relevant laws. The Institutional Review Board determined consent could be waived for this study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"N\/A.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}