{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T17:40:48Z","timestamp":1791567648433,"version":"4.3.4"},"reference-count":126,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2023,8,16]],"date-time":"2023-08-16T00:00:00Z","timestamp":1692144000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"AbbVie"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Although topical medical therapy and selective-laser-trabeculoplasty represent the treatments of choice to reduce intraocular pressure, many patients do not achieve adequate glaucoma control; therefore, they require further options and eventually surgery. Trabeculectomy is still considered the gold standard, but the surgical management of glaucoma has undergone continuous advances in recent years, XEN-gel-stent has been introduced as a safer and less traumatic means of lowering intraocular pressure (IOP) in patients with open-angle glaucoma (OAG). This study aimed to review the effectiveness and safety of clinical data on XEN-stent in OAG patients with a Synthesis-Without-Meta-analysis (SWiM) methodology. A total of 339 studies were identified following a literature search adhering to PRISMA guidelines and, after evaluation, 96 studies are discussed. XEN63 and XEN45 device data were collected both short and long term. In addition, this document has evaluated different aspects related to the XEN implant, including: its role compared to trabeculectomy; the impact of mitomycin-C dose on clinical outcomes; postoperative management of the device; and the identification of potential factors that might predict its clinical outcomes. Finally, current challenges and future perspectives of XEN stent, such as its use in fragile or high myopia patients, were discussed.<\/jats:p>","DOI":"10.3390\/jcm12165339","type":"journal-article","created":{"date-parts":[[2023,8,16]],"date-time":"2023-08-16T10:09:33Z","timestamp":1692180573000},"page":"5339","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":36,"title":["Effectiveness and Safety of Xen Gel Stent in Glaucoma Surgery: A Systematic Review of the Literature"],"prefix":"10.3390","volume":"12","author":[{"given":"Carlo Enrico","family":"Traverso","sequence":"first","affiliation":[{"name":"Eye Clinic, IRCCS San Martino Polyclinic Hospital, 16132 Genoa, Italy"},{"name":"Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, 16126 Genoa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto G.","family":"Carassa","sequence":"additional","affiliation":[{"name":"Centro Italiano Glaucoma, 20124 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio Maria","family":"Fea","sequence":"additional","affiliation":[{"name":"Department of Surgical Sciences, University of Turin, 10122 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2243-9033","authenticated-orcid":false,"given":"Michele","family":"Figus","sequence":"additional","affiliation":[{"name":"Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, 56126 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo","family":"Astarita","sequence":"additional","affiliation":[{"name":"AbbVie S.r.l., 04011 Campoverde, LT, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benedetta","family":"Piergentili","sequence":"additional","affiliation":[{"name":"AbbVie S.r.l., 04011 Campoverde, LT, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2294-0055","authenticated-orcid":false,"given":"Vanessa","family":"Vera","sequence":"additional","affiliation":[{"name":"AbbVie Inc., North Chicago, IL 60064, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Gandolfi","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery, University of Parma, 43121 Parma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,8,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"16067","DOI":"10.1038\/nrdp.2016.67","article-title":"Primary open-angle glaucoma","volume":"2","author":"Weinreb","year":"2016","journal-title":"Nat. Rev. Dis. Prim."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1268","DOI":"10.1001\/archopht.120.10.1268","article-title":"Reduction of intraocular pressure and glaucoma progression: Results from the Early Manifest Glaucoma Trial","volume":"120","author":"Heijl","year":"2002","journal-title":"Arch. Ophthalmol."},{"key":"ref_3","unstructured":"(2021). European Glaucoma Society Terminology and Guidelines for Glaucoma, 5th Edition. Br. J. Ophthalmol., 105, 1\u2013169."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1943","DOI":"10.1016\/S0161-6420(01)00873-9","article-title":"Interim clinical outcomes in the Collaborative Initial Glaucoma Treatment Study comparing initial treatment randomized to medications or surgery","volume":"108","author":"Lichter","year":"2001","journal-title":"Ophthalmology"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1308","DOI":"10.1016\/j.ophtha.2015.03.026","article-title":"The Most Common Barriers to Glaucoma Medication Adherence: A Cross-Sectional Survey","volume":"122","author":"Robin","year":"2015","journal-title":"Ophthalmology"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"694","DOI":"10.1016\/j.ophtha.2011.09.043","article-title":"A twenty-year follow-up study of trabeculectomy: Risk factors and outcomes","volume":"119","author":"Landers","year":"2012","journal-title":"Ophthalmology"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1016\/j.ajo.2005.02.013","article-title":"Perioperative complications of trabeculectomy in the collaborative initial glaucoma treatment study (CIGTS)","volume":"140","author":"Jampel","year":"2005","journal-title":"Am. J. Ophthalmol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e0024","DOI":"10.5041\/RMMJ.10345","article-title":"Evolution of Glaucoma Surgery in the Last 25 Years","volume":"9","author":"Blumenthal","year":"2018","journal-title":"Rambam Maimonides Med. J."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1097\/ICU.0b013e32834ff1e7","article-title":"Micro-invasive glaucoma surgery: Current perspectives and future directions","volume":"23","author":"Saheb","year":"2012","journal-title":"Curr. Opin. Ophthalmol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1737","DOI":"10.1016\/j.ophtha.2015.06.022","article-title":"MIGS and the FDA: What\u2019s in a Name?","volume":"122","author":"Ahmed","year":"2015","journal-title":"Ophthalmology"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1795","DOI":"10.1016\/j.ophtha.2015.02.029","article-title":"Special Commentary: Supporting Innovation for Safe and Effective Minimally Invasive Glaucoma Surgery: Summary of a Joint Meeting of the American Glaucoma Society and the Food and Drug Administration, Washington, DC, February 26, 2014","volume":"122","author":"Caprioli","year":"2015","journal-title":"Ophthalmology"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"804847","DOI":"10.3389\/fmed.2022.804847","article-title":"The Outcomes of XEN Gel Stent Implantation: A Systematic Review and Meta-Analysis","volume":"9","author":"Chen","year":"2022","journal-title":"Front. Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1301","DOI":"10.1016\/j.jcrs.2014.01.032","article-title":"Ab interno approach to the subconjunctival space using a collagen glaucoma stent","volume":"40","author":"Lewis","year":"2014","journal-title":"J. Cataract. Refract. Surg."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Lavia, C., Dallorto, L., Maule, M., Ceccarelli, M., and Fea, A.M. (2017). Minimally-invasive glaucoma surgeries (MIGS) for open angle glaucoma: A systematic review and meta-analysis. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0183142"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1007\/s40123-017-0098-2","article-title":"An Update on Implants for Minimally Invasive Glaucoma Surgery (MIGS)","volume":"6","author":"Ansari","year":"2017","journal-title":"Ophthalmol. Ther."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"3594","DOI":"10.1167\/iovs.16-19453","article-title":"Biocompatibility of a Novel Microfistula Implant in Nonprimate Mammals for the Surgical Treatment of Glaucoma","volume":"57","author":"Shute","year":"2016","journal-title":"Investig. Opthalmol. Vis. Sci."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"e691","DOI":"10.1097\/IJG.0000000000000352","article-title":"Early Clinical Results of a Novel Ab Interno Gel Stent for the Surgical Treatment of Open-angle Glaucoma","volume":"25","author":"Sheybani","year":"2016","journal-title":"J. Glaucoma"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1905","DOI":"10.1016\/j.jcrs.2015.01.019","article-title":"Phacoemulsification combined with a new ab interno gel stent to treat open-angle glaucoma: Pilot study","volume":"41","author":"Sheybani","year":"2015","journal-title":"J. Cataract. Refract. Surg."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1111\/ceo.13463","article-title":"Four-year results of a minimally invasive transscleral glaucoma gel stent implantation in a prospective multi-centre study","volume":"47","author":"Lenzhofer","year":"2019","journal-title":"Clin. Exp. Ophthalmol."},{"key":"ref_20","first-page":"4796548","article-title":"Comparing Medium-Term Clinical Outcomes following XEN\u00ae 45 and XEN\u00ae 63 Device Implantation","volume":"2020","author":"Zhou","year":"2020","journal-title":"J. Ophthalmol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1829","DOI":"10.1177\/1120672120952033","article-title":"XEN 63 gel stent device in glaucoma surgery: A 5-years follow-up prospective study","volume":"31","year":"2021","journal-title":"Eur. J. Ophthalmol."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Fea, A.M., Menchini, M., Rossi, A., Posarelli, C., Malinverni, L., and Figus, M. (2021). Early Experience with the New XEN63 Implant in Primary Open-Angle Glaucoma Patients: Clinical Outcomes. J. Clin. Med., 10.","DOI":"10.3390\/jcm10081628"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Fea, A.M., Menchini, M., Rossi, A., Posarelli, C., Malinverni, L., and Figus, M. (2022). Outcomes of XEN 63 Device at 18-Month Follow-Up in Glaucoma Patients: A Two-Center Retrospective Study. J. Clin. Med., 11.","DOI":"10.3390\/jcm11133801"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"2538","DOI":"10.1007\/s12325-020-01278-1","article-title":"XEN Gel Stent Open Conjunctiva Technique: A Practical Approach Paper","volume":"37","author":"Panarelli","year":"2020","journal-title":"Adv. Ther."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"2361","DOI":"10.2147\/OPTH.S265695","article-title":"Surgical Approaches for Implanting Xen Gel Stent without Conjunctival Dissection","volume":"14","author":"Vera","year":"2020","journal-title":"Clin. Ophthalmol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"299","DOI":"10.2147\/OPTH.S292007","article-title":"Comparison of Safety and Efficacy Between Ab Interno and Ab Externo Approaches to XEN Gel Stent Placement","volume":"15","author":"Tan","year":"2021","journal-title":"Clin. Ophthalmol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1038\/d41586-018-05414-4","article-title":"Four principles to make evidence synthesis more useful for policy","volume":"558","author":"Donnelly","year":"2018","journal-title":"Nature"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"b2700","DOI":"10.1136\/bmj.b2700","article-title":"The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: Explanation and elaboration","volume":"339","author":"Liberati","year":"2009","journal-title":"BMJ"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1209","DOI":"10.1016\/j.jclinepi.2013.06.004","article-title":"Complex interventions and their implications for systematic reviews: A pragmatic approach","volume":"66","author":"Petticrew","year":"2013","journal-title":"J. Clin. Epidemiol."},{"key":"ref_30","unstructured":"Cochrane Collaboration (2023, April 21). Cochrane Strategy to 2020. Available online: https:\/\/community.cochrane.org\/sites\/default\/files\/uploads\/00%20S2020%202017%20Targets%20End%20of%20Year%20Report.pdf."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Smith, E.A., Cooper, N.J., Sutton, A.J., Abrams, K.R., and Hubbard, S.J. (2021). A review of the quantitative effectiveness evidence synthesis methods used in public health intervention guidelines. BMC Public Health, 21.","DOI":"10.1186\/s12889-021-10162-8"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1177\/0193841X16674421","article-title":"Synthesizing Evidence in Public Policy Contexts: The Challenge of Synthesis When There Are Only a Few Studies","volume":"41","author":"Valentine","year":"2017","journal-title":"Eval. Rev."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jclinepi.2018.08.019","article-title":"Lack of transparency in reporting narrative synthesis of quantitative data: A methodological assessment of systematic reviews","volume":"105","author":"Campbell","year":"2019","journal-title":"J. Clin. Epidemiol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"l6890","DOI":"10.1136\/bmj.l6890","article-title":"Synthesis without meta-analysis (SWiM) in systematic reviews: Reporting guideline","volume":"368","author":"Campbell","year":"2020","journal-title":"BMJ"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Moher, D., Liberati, A., Tetzlaff, J., Altman, D.G., and PRISMA Group (2009). Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. PLoS Med., 6.","DOI":"10.1371\/journal.pmed.1000097"},{"key":"ref_36","first-page":"415","article-title":"Combined phacoemulsification and XEN45 surgery from a temporal approach and 2 incisions","volume":"91","year":"2016","journal-title":"Arch Soc. Esp. Oftalmol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"382","DOI":"10.5935\/0004-2749.20170093","article-title":"An innovation in glaucoma surgery: XEN45 gel stent implantation","volume":"80","author":"Ozal","year":"2017","journal-title":"Arq. Bras. Oftalmol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"5457246","DOI":"10.1155\/2017\/5457246","article-title":"XEN Glaucoma Implant with Mitomycin C 1-Year Follow-Up: Result and Complications","volume":"2017","author":"Galal","year":"2017","journal-title":"J. Ophthalmol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1016\/j.ajo.2017.07.023","article-title":"Performance and Safety of a New Ab Interno Gelatin Stent in Refractory Glaucoma at 12 Months","volume":"183","author":"Grover","year":"2017","journal-title":"Am. J. Ophthalmol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1130","DOI":"10.1097\/IJG.0000000000000803","article-title":"Ab Interno Gel Implant for the Treatment of Glaucoma Patients with or Without Prior Glaucoma Surgery: 1-Year Results","volume":"26","author":"Hengerer","year":"2017","journal-title":"J. Glaucoma"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1129","DOI":"10.1007\/s10792-017-0571-x","article-title":"Minimally invasive combined glaucoma and cataract surgery: Clinical results of the smallest ab interno gel stent","volume":"38","author":"Pedrotti","year":"2018","journal-title":"Int. Ophthalmol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1097\/IJG.0000000000000858","article-title":"Prospective Evaluation of Standalone XEN Gel Implant and Combined Phacoemulsification-XEN Gel Implant Surgery: 1-Year Results","volume":"27","author":"Mansouri","year":"2018","journal-title":"J. Glaucoma"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1038\/eye.2017.162","article-title":"One-year result of XEN45 implant for glaucoma: Efficacy, safety, and postoperative management","volume":"32","author":"Tan","year":"2018","journal-title":"Eye"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"765","DOI":"10.1007\/s00417-018-3899-7","article-title":"The XEN45 Gel Stent as a minimally invasive procedure in glaucoma surgery: Success rates, risk profile, and rates of re-surgery after 261 surgeries","volume":"256","author":"Widder","year":"2018","journal-title":"Graefes Arch. Clin. Exp. Ophthalmol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"983","DOI":"10.1007\/s00417-019-04251-z","article-title":"Two-year results of a multicenter study of the ab interno gelatin implant in medically uncontrolled primary open-angle glaucoma","volume":"257","author":"Reitsamer","year":"2019","journal-title":"Graefes Arch. Clin. Exp. Ophthalmol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1061","DOI":"10.1097\/IJG.0000000000001389","article-title":"Urgent Management of Secondary Glaucoma in Uveitis Using the Xen-45 Gel Stent","volume":"28","author":"Qureshi","year":"2019","journal-title":"J. Glaucoma"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1007\/s40123-019-0192-8","article-title":"XEN\u00ae Gel Stent in Medically Refractory Open-Angle Glaucoma: Results and Observations After One Year of Use in the United States","volume":"8","author":"Kalina","year":"2019","journal-title":"Ophthalmol. Ther."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1741","DOI":"10.1007\/s00417-019-04341-y","article-title":"XEN implant device versus trabeculectomy, either alone or in combination with phacoemulsification, in open-angle glaucoma patients","volume":"257","author":"Parra","year":"2019","journal-title":"Graefes Arch. Clin. Exp. Ophthalmol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"2707","DOI":"10.1007\/s00417-019-04452-6","article-title":"Change in visual acuity 12 and 24 months after transscleral ab interno glaucoma gel stent implantation with adjunctive Mitomycin C","volume":"257","author":"Lenzhofer","year":"2019","journal-title":"Graefes Arch. Clin. Exp. Ophthalmol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"3519","DOI":"10.1007\/s12325-019-01127-w","article-title":"Case Series of Combined XEN Implantation and Phacoemulsification in Chinese Eyes: One-Year Outcomes","volume":"36","author":"Sng","year":"2019","journal-title":"Adv. Ther."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1125","DOI":"10.1136\/bjophthalmol-2019-313870","article-title":"Efficacy and safety data for the XEN45 implant at 2 years: A retrospective analysis","volume":"104","author":"Gabbay","year":"2020","journal-title":"Br. J. Ophthalmol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"1250","DOI":"10.18240\/ijo.2020.08.11","article-title":"Efficacy and safety of XEN 45 gel stent alone or in combination with phacoemulsification in advanced open angle glaucoma patients: 1-year retrospective study","volume":"13","year":"2020","journal-title":"Int. J. Ophthalmol."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1097\/IJG.0000000000001122","article-title":"A Retrospective Study of 199 Xen45 Stent Implantations from 2014 to 2016","volume":"28","author":"Heidinger","year":"2019","journal-title":"J. Glaucoma"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1177\/1120672118795063","article-title":"One-year follow-up of the XEN\u00ae implant with mitomycin-C in pseudoexfoliative glaucoma patients","volume":"29","year":"2019","journal-title":"Eur. J. Ophthalmol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1038\/s41433-018-0243-8","article-title":"A multi-centre interventional case series of 259 ab-interno Xen gel implants for glaucoma, with and without combined cataract surgery","volume":"33","author":"Karimi","year":"2019","journal-title":"Eye"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"229","DOI":"10.4103\/meajo.MEAJO_126_19","article-title":"Real-World Retrospective Consecutive Study of Ab Interno XEN 45 Gel Stent Implant with Mitomycin C in Black and Afro-Latino Patients with Glaucoma: 40% Required Secondary Glaucoma Surgery at 1 Year","volume":"26","author":"Laroche","year":"2020","journal-title":"Middle East Afr. J. Ophthalmol."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"761","DOI":"10.1038\/s41433-018-0310-1","article-title":"1-year outcomes of the Xen45 glaucoma implant","volume":"33","author":"Smith","year":"2019","journal-title":"Eye"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1005","DOI":"10.1007\/s00417-019-04272-8","article-title":"Optical coherence tomography analysis of filtering blebs after long-term, functioning trabeculectomy and XEN\u00ae stent implant","volume":"257","author":"Teus","year":"2019","journal-title":"Graefes Arch. Clin. Exp. Ophthalmol."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1016\/j.ogla.2019.03.011","article-title":"Two-Year Outcomes of XEN Gel Stent Surgery in Patients with Open-Angle Glaucoma","volume":"2","author":"Mansouri","year":"2019","journal-title":"Ophthalmol. Glaucoma"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"e531","DOI":"10.1111\/aos.14605","article-title":"Combined and stand-alone XEN 45 gel stent implantation: 3-year outcomes and success predictors","volume":"99","author":"Gillmann","year":"2021","journal-title":"Acta Ophthalmol."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1007\/s10633-020-09753-4","article-title":"XEN Gel Stent in the management of primary open-angle glaucoma","volume":"141","author":"Post","year":"2020","journal-title":"Doc. Ophthalmol."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"1787","DOI":"10.1007\/s00417-020-04654-3","article-title":"XEN-augmented Baerveldt drainage device implantation in refractory glaucoma: 1-year outcomes","volume":"258","author":"Bravetti","year":"2020","journal-title":"Graefes Arch. Clin. Exp. Ophthalmol."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"e433","DOI":"10.1111\/aos.14602","article-title":"XEN\u00ae Gel Stent compared to PRESERFLO\u2122 MicroShunt implantation for primary open-angle glaucoma: Two-year results","volume":"99","author":"Scheres","year":"2021","journal-title":"Acta Ophthalmol."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1097\/JCMA.0000000000000430","article-title":"XEN45 Gel Stent implantation in eyes with primary open angle glaucoma: A study from a single hospital in Taiwan","volume":"84","author":"Chao","year":"2021","journal-title":"J. Chin. Med. Assoc."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"1085","DOI":"10.1007\/s10792-019-01271-w","article-title":"XEN gel implant versus gonioscopy-assisted transluminal trabeculotomy for the treatment of open-angle glaucoma","volume":"40","author":"Olgun","year":"2020","journal-title":"Int. Ophthalmol."},{"key":"ref_66","doi-asserted-by":"crossref","unstructured":"Schargus, M., Theilig, T., Rehak, M., Busch, C., Bormann, C., and Unterlauft, J.D. (2020). Outcome of a single XEN microstent implant for glaucoma patients with different types of glaucoma. BMC Ophthalmol., 20.","DOI":"10.1186\/s12886-020-01764-8"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"19337","DOI":"10.1038\/s41598-020-76551-y","article-title":"Comparing the efficacy of trabeculectomy and XEN gel microstent implantation for the treatment of primary open-angle glaucoma: A retrospective monocentric comparative cohort study","volume":"10","author":"Theilig","year":"2020","journal-title":"Sci. Rep."},{"key":"ref_68","doi-asserted-by":"crossref","unstructured":"Theillac, V., Blumen-Ohana, E., Akesbi, J., Hamard, P., Sellam, A., Brasnu, E., Baudouin, C., Labbe, A., and Nordmann, J.P. (2020). Cataract and glaucoma combined surgery: XEN\u00ae gel stent versus nonpenetrating deep sclerectomy, a pilot study. BMC Ophthalmol., 20.","DOI":"10.1186\/s12886-020-01492-z"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"139","DOI":"10.4274\/tjo.galenos.2020.47629","article-title":"A Retrospective Analysis of Safety and Efficacy of XEN 45 Microstent Combined Cataract Surgery in Open-Angle Glaucoma over 24 Months","volume":"51","author":"Tugan","year":"2021","journal-title":"Turk. J. Ophthalmol."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1097\/j.jcrs.0000000000000065","article-title":"European study of the efficacy of a cross-linked gel stent for the treatment of glaucoma","volume":"46","author":"Fea","year":"2020","journal-title":"J. Cataract. Refract. Surg."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1111\/aos.14627","article-title":"Two-year outcomes of minimally invasive XEN Gel Stent implantation in primary open-angle and pseudoexfoliation glaucoma","volume":"99","author":"Rauchegger","year":"2021","journal-title":"Acta Ophthalmol."},{"key":"ref_72","doi-asserted-by":"crossref","unstructured":"Wagner, F.M., Schuster, A.K., Emmerich, J., Chronopoulos, P., and Hoffmann, E.M. (2020). Efficacy and safety of XEN\u00ae\u2013Implantation vs. trabeculectomy: Data of a \u201creal-world\u201d setting. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0231614"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"3719","DOI":"10.2147\/OPTH.S267010","article-title":"Learning Curve and One-Year Outcome of XEN 45 Gel Stent Implantation in a Swedish Population","volume":"14","author":"Busch","year":"2020","journal-title":"Clin. Ophthalmol."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"932","DOI":"10.1097\/IJG.0000000000001582","article-title":"Automated Gonioscopy Assessment of XEN45 Gel Stent Angle Location After Isolated XEN or Combined Phaco-XEN Procedures: Clinical Implications","volume":"29","author":"Teixeira","year":"2020","journal-title":"J. Glaucoma"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"2487","DOI":"10.1007\/s10792-020-01427-z","article-title":"Xen implantation in patients with primary open-angle glaucoma: Comparison of two different techniques","volume":"40","author":"Ucar","year":"2020","journal-title":"Int. Ophthalmol."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"1003","DOI":"10.1111\/ceo.13799","article-title":"Efficacy of the Ologen collagen matrix in combination with the XEN gel stent implantation in the treatment of open-angle glaucoma: A case-control study","volume":"48","author":"Anton","year":"2020","journal-title":"Clin. Exp. Ophthalmol."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1097\/IJG.0000000000001823","article-title":"A Comparison of Clinical Outcomes After XEN Gel Stent and EX-PRESS Glaucoma Drainage Device Implantation","volume":"30","author":"Stoner","year":"2021","journal-title":"J. Glaucoma"},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"64","DOI":"10.5005\/jp-journals-10078-1304","article-title":"Outcomes of XEN Gel Stent Implantation in the Inferonasal Quadrant after Failed Trabeculectomy","volume":"15","author":"Olgun","year":"2021","journal-title":"J. Curr. Glaucoma Pract."},{"key":"ref_79","doi-asserted-by":"crossref","unstructured":"Schargus, M., Busch, C., Rehak, M., Meng, J., Schmidt, M., Bormann, C., and Unterlauft, J.D. (2021). Functional Monitoring after Trabeculectomy or XEN Microstent Implantation Using Spectral Domain Optical Coherence Tomography and Visual Field Indices-A Retrospective Comparative Cohort Study. Biology, 10.","DOI":"10.3390\/biology10040273"},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"839","DOI":"10.1080\/08820538.2021.1931356","article-title":"A Retrospective Comparison of Trabeculectomy, Baerveldt Glaucoma Implant, and Microinvasive Glaucoma Surgeries in a Three-Year Follow-Up","volume":"36","author":"Nuzzi","year":"2021","journal-title":"Semin. Ophthalmol."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"3371","DOI":"10.1007\/s10792-021-01899-7","article-title":"Multicenter case series of standalone XEN implant vs. combination with phacoemulsification in Turkish patients","volume":"41","author":"Eraslan","year":"2021","journal-title":"Int. Ophthalmol."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1055\/a-1553-4547","article-title":"Implantation of XEN After Failed Trabeculectomy: An Efficient Therapy?","volume":"239","author":"Bormann","year":"2022","journal-title":"Klin. Monbl. Augenheilkd."},{"key":"ref_83","doi-asserted-by":"crossref","unstructured":"Lewczuk, K., Konopi\u0144ska, J., Jab\u0142o\u0144ska, J., Rudowicz, J., Laszewicz, P., Dmuchowska, D.A., Mariak, Z., and R\u0119kas, M. (2021). XEN Glaucoma Implant for the Management of Glaucoma in Na\u00efve Patients versus Patients with Previous Glaucoma Surgery. J. Clin. Med., 10.","DOI":"10.3390\/jcm10194417"},{"key":"ref_84","doi-asserted-by":"crossref","unstructured":"Wanichwecharungruang, B., and Ratprasatporn, N. (2021). 24-month outcomes of XEN45 gel implant versus trabeculectomy in primary glaucoma. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0256362"},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"2321922","DOI":"10.1155\/2021\/2321922","article-title":"XEN Glaucoma Implant for the Management of Operated Uncontrolled Glaucoma: Results and Complications during a Long-Term Follow-Up","volume":"2021","author":"Lewczuk","year":"2021","journal-title":"J. Ophthalmol."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"e233","DOI":"10.1111\/aos.14886","article-title":"Three-year effectiveness and safety of the XEN gel stent as a solo procedure or in combination with phacoemulsification in open-angle glaucoma: A multicentre study","volume":"100","author":"Reitsamer","year":"2022","journal-title":"Acta Ophthalmol."},{"key":"ref_87","first-page":"11206721211014381","article-title":"Efficacy and safety data for the Ab interno XEN45 gel stent implant at 3 Years: A retrospective analysis","volume":"32","author":"Gabbay","year":"2021","journal-title":"Eur. J. Ophthalmol."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"3087","DOI":"10.1177\/1120672120963447","article-title":"Needling after XEN gel implant: What\u2019s the efficacy? A 1-year analysis","volume":"31","author":"Teixeira","year":"2021","journal-title":"Eur. J. Ophthalmol."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"881","DOI":"10.1007\/s10792-021-02069-5","article-title":"A retrospective review of XEN implant surgery: Efficacy, safety and the effect of combined cataract surgery","volume":"42","author":"Nicolaou","year":"2022","journal-title":"Int. Ophthalmol."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"e968","DOI":"10.1111\/aos.14684","article-title":"Implantation of the XEN\u00ae 45 Gel Stent in patients with glaucoma at a University Hospital\u2014A retrospective quality control study","volume":"99","author":"Olsen","year":"2021","journal-title":"Acta Ophthalmol."},{"key":"ref_91","first-page":"365","article-title":"Efficacy and safety of Ab interno XEN gel implant after a failed filtering surgery","volume":"65","author":"Franco","year":"2021","journal-title":"Romnian J. Ophthalmol."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"2761","DOI":"10.1007\/s00417-021-05204-1","article-title":"Needling and open filtering bleb revision after XEN-45 implantation\u2013A retrospective outcome comparison","volume":"259","author":"Steiner","year":"2021","journal-title":"Graefes Arch. Clin. Exp. Ophthalmol."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"e000830","DOI":"10.1136\/bmjophth-2021-000830","article-title":"Trabeculectomy versus Xen gel implant for the treatment of open-angle glaucoma: A 3-year retrospective analysis","volume":"7","author":"Cappelli","year":"2022","journal-title":"BMJ Open Ophthalmol."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1016\/j.jcjo.2022.02.012","article-title":"Efficacy of ab-interno gelatin microstent implantation in primary and refractory glaucoma","volume":"58","author":"Szigiato","year":"2022","journal-title":"Can. J. Ophthalmol."},{"key":"ref_95","first-page":"2649","article-title":"Does mitomycin-C concentration have any influence on XEN45 gel stent outcomes in a real-world setting?","volume":"260","year":"2022","journal-title":"Graefes Arch. Clin. Exp. Ophthalmol."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"935","DOI":"10.2147\/OPTH.S357575","article-title":"Impact of Primary Needling on the XEN Implant Clinical Outcomes: A Real-Life Retrospective Study","volume":"16","year":"2022","journal-title":"Clin. Ophthalmol."},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1055\/a-1766-7320","article-title":"Two-Year Outcome of Surgery in Glaucoma Patients","volume":"239","author":"Wagels","year":"2022","journal-title":"Klin. Monbl. Augenheilkd."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1097\/IJG.0000000000001295","article-title":"XEN Gel Stent in Pseudoexfoliative Glaucoma: 2-Year Results of a Prospective Evaluation","volume":"28","author":"Gillmann","year":"2019","journal-title":"J. Glaucoma"},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1097\/IJG.0000000000002206","article-title":"XEN Gel Stent Versus Non-penetrating Deep Sclerectomy in Ocular-hypertension and Open-angle Glaucoma Patients","volume":"32","year":"2023","journal-title":"J. Glaucoma"},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"1223","DOI":"10.2147\/OPTH.S405821","article-title":"Long-Term Effectiveness of XEN 45 Gel-Stent in Open-Angle Glaucoma Patients","volume":"17","year":"2023","journal-title":"Clin. Ophthalmol."},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1111\/ceo.14181","article-title":"Outcomes of 45 \u03bcm gelatin stent surgery over 24-monthfollow-up","volume":"51","author":"Vukmirovic","year":"2023","journal-title":"Clin. Exp. Ophthalmol."},{"key":"ref_102","doi-asserted-by":"crossref","unstructured":"Yang, X., Zhao, Y., Zhong, Y., and Duan, X. (2022). The efficacy of XEN gel stent implantation in glaucoma: A systematic review and meta-analysis. BMC Ophthalmol., 22.","DOI":"10.1186\/s12886-022-02502-y"},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"25","DOI":"10.2147\/OPTH.S390955","article-title":"Intraocular Pressure and Medication Changes Associated with Xen Gel Stent: A Systematic Review of the Literature","volume":"17","author":"Panarelli","year":"2023","journal-title":"Clin. Ophthalmol."},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1007\/s00347-019-00950-4","article-title":"Hohe Myopie bei vitrektomiertem Auge: Kontraindikation f\u00fcr minimal-invasive glaukomchirurgische Implantate?","volume":"117","author":"Huth","year":"2020","journal-title":"Ophthalmologe"},{"key":"ref_105","doi-asserted-by":"crossref","unstructured":"Sacchi, M., Fea, A.M., Monsellato, G., Tagliabue, E., Villani, E., Ranno, S., and Nucci, P. (2023). Safety and Efficacy of Ab Interno XEN 45 Gel Stent in Patients with Glaucoma and High Myopia. J. Clin. Med., 12.","DOI":"10.3390\/jcm12072477"},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1097\/IJG.0000000000002151","article-title":"Effectiveness and Safety of XEN45 in Eyes With High Myopia and Open Angle Glaucoma","volume":"32","author":"Fea","year":"2023","journal-title":"J. Glaucoma"},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"1309","DOI":"10.21037\/atm-20-6354","article-title":"XEN gel implant with or without phacoemulsification for glaucoma: A systematic review and meta-analysis","volume":"8","author":"Wang","year":"2020","journal-title":"Ann. Transl. Med."},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1016\/j.ajo.2023.03.026","article-title":"Gel Stent vs Trabeculectomy: The Randomized, Multicenter, Gold Standard Pathway Study (GPS) of Effectiveness and Safety at 12 Months: Gel Stent vs Trabeculectomy: A Prospective Randomized Study","volume":"252","author":"Sheybani","year":"2023","journal-title":"Am. J. Ophthalmol."},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"1579","DOI":"10.1016\/j.ophtha.2017.05.004","article-title":"Efficacy, Safety, and Risk Factors for Failure of Standalone Ab Interno Gelatin Microstent Implantation versus Standalone Trabeculectomy","volume":"124","author":"Schlenker","year":"2017","journal-title":"Ophthalmology"},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"1763","DOI":"10.1007\/s00417-020-04671-2","article-title":"Structural imaging of conjunctival filtering blebs in XEN gel implantation and trabeculectomy: A confocal and anterior segment optical coherence tomography study","volume":"258","author":"Sacchi","year":"2020","journal-title":"Graefes Arch. Clin. Exp. Ophthalmol."},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1177\/1120672120924339","article-title":"XEN Gel Stent versus trabeculectomy: Short-term effects on corneal endothelial cells","volume":"31","author":"Olgun","year":"2021","journal-title":"Eur. J. Ophthalmol."},{"key":"ref_112","first-page":"CD006259","article-title":"Mitomycin C versus 5-Fluorouracil for wound healing in glaucoma surgery","volume":"2015","author":"Cabourne","year":"2015","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_113","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1016\/j.survophthal.2020.05.005","article-title":"Learning from the past: Mitomycin C use in trabeculectomy and its application in bleb-forming minimally invasive glaucoma surgery","volume":"66","author":"Bell","year":"2021","journal-title":"Surv. Ophthalmol."},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1097\/IJG.0000000000001394","article-title":"Efficacy of Needling Revision After XEN Gel Stent Implantation: A Prospective Study","volume":"29","author":"Midha","year":"2020","journal-title":"J. Glaucoma"},{"key":"ref_115","doi-asserted-by":"crossref","first-page":"594","DOI":"10.1097\/IJG.0b013e318181283e","article-title":"Needle revision of filtering blebs","volume":"17","author":"Feldman","year":"2008","journal-title":"J. Glaucoma"},{"key":"ref_116","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1016\/j.ogla.2021.02.004","article-title":"Primary Needling of the Ab Interno Gelatin Microstent Reduces Postoperative Needling and Follow-up Requirements","volume":"4","author":"Kerr","year":"2021","journal-title":"Ophthalmol. Glaucoma"},{"key":"ref_117","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/j.ajo.2006.07.022","article-title":"Surgical complications in the Tube Versus Trabeculectomy Study during the first year of follow-up","volume":"143","author":"Gedde","year":"2007","journal-title":"Am. J. Ophthalmol."},{"key":"ref_118","doi-asserted-by":"crossref","first-page":"416","DOI":"10.3341\/kjo.2016.30.6.416","article-title":"Changes in Corneal Endothelial Cell after Ahmed Glaucoma Valve Implantation and Trabeculectomy: 1-Year Follow-up","volume":"30","author":"Kim","year":"2016","journal-title":"Korean J. Ophthalmol."},{"key":"ref_119","doi-asserted-by":"crossref","first-page":"301","DOI":"10.29271\/jcpsp.2018.04.301","article-title":"Comparison of Mean Corneal Endothelial Cell Loss after Trabeculectomy with and without Mitomycin C","volume":"28","author":"Shaheer","year":"2018","journal-title":"J. Coll. Physicians Surg. Pak."},{"key":"ref_120","doi-asserted-by":"crossref","unstructured":"Iwasaki, K., Arimura, S., Takihara, Y., Takamura, Y., and Inatani, M. (2018). Prospective cohort study of corneal endothelial cell loss after Baerveldt glaucoma implantation. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0201342"},{"key":"ref_121","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1097\/IJG.0000000000001430","article-title":"Impact of Phacoemulsification Combined with XEN Gel Stent Implantation on Corneal Endothelial Cell Density: 2-Year Results","volume":"29","author":"Gillmann","year":"2020","journal-title":"J. Glaucoma"},{"key":"ref_122","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1097\/IJG.0000000000001840","article-title":"Endothelial Cell Density After XEN Implant Surgery: Short-term Data from the Italian XEN Glaucoma Treatment Registry (XEN-GTR)","volume":"30","author":"Oddone","year":"2021","journal-title":"J. Glaucoma"},{"key":"ref_123","doi-asserted-by":"crossref","first-page":"1073","DOI":"10.1007\/s00417-022-05898-x","article-title":"Five-year follow-up of corneal endothelial cell density after transscleral ab interno glaucoma gel stent implantation","volume":"261","author":"Lenzhofer","year":"2023","journal-title":"Graefes Arch. Clin. Exp. Ophthalmol."},{"key":"ref_124","doi-asserted-by":"crossref","first-page":"804","DOI":"10.1016\/j.ajo.2011.10.024","article-title":"Postoperative complications in the Tube Versus Trabeculectomy (TVT) study during five years of follow-up","volume":"153","author":"Gedde","year":"2012","journal-title":"Am. J. Ophthalmol."},{"key":"ref_125","doi-asserted-by":"crossref","first-page":"2532","DOI":"10.1016\/j.ophtha.2013.07.049","article-title":"Trabeculectomy in the 21st century: A multicenter analysis","volume":"120","author":"Kirwan","year":"2013","journal-title":"Ophthalmology"},{"key":"ref_126","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1016\/j.ophtha.2019.10.002","article-title":"Treatment Outcomes in the Primary Tube Versus Trabeculectomy Study after 3 Years of Follow-up","volume":"127","author":"Gedde","year":"2020","journal-title":"Ophthalmology"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/16\/5339\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T20:35:14Z","timestamp":1760128514000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/16\/5339"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,16]]},"references-count":126,"journal-issue":{"issue":"16","published-online":{"date-parts":[[2023,8]]}},"alternative-id":["jcm12165339"],"URL":"https:\/\/doi.org\/10.3390\/jcm12165339","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8,16]]}}}