{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T02:39:47Z","timestamp":1760150387793,"version":"build-2065373602"},"reference-count":15,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2023,11,2]],"date-time":"2023-11-02T00:00:00Z","timestamp":1698883200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vision"],"abstract":"<jats:p>We aimed to describe a variation of the surgical technique for the ab interno implantation of the XEN Gel Stent, which, in our experience, is yielding very successful results. The injection of 0.1 mL of air and then of 0.1 mL of a dispersive viscoelastic into the subconjunctival space at the beginning of the surgery allows one to perform a mechanical dissection between the conjunctiva and the Tenon\u2019s capsule, creating a real space. In total, 20 eyes of 16 patients underwent the implantation of a stent gel through the \u201cAir and Visco\u201d technique. We retrospectively analyzed the results. We obtained a reduction in the IOP from an average of 18.3 \u00b1 2.2 mmHg preoperatively to at 13.5 \u00b1 3.5 mmHg at month 12. The needling rate was 20%. We did not register any cases of hypotony (IOP &lt; 6 mmHg), hypotony maculopathy or choroidal detachment. The \u201cAir and Visco\u201d technique allows one to correctly place the device in the subconjunctival space, which the pneumo- and visco-dissection transforms into a real space. This enables an easier surgical performance and more predictable postoperative results, with a low needling rate and reintervention in the follow-up period. It also ensures a greater safety profile because the presence of the OVD on the bleb prevents a sudden lowering of the IOP, eliminating complications such as hypotony, hypotony maculopathy and choroidal detachment in our cohort.<\/jats:p>","DOI":"10.3390\/vision7040071","type":"journal-article","created":{"date-parts":[[2023,11,3]],"date-time":"2023-11-03T02:41:56Z","timestamp":1698979316000},"page":"71","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["\u201cAir and Visco\u201d Technique: A Promising Innovation in the Surgical Implantation of the Xen Gel Stent Device"],"prefix":"10.3390","volume":"7","author":[{"given":"Fabrizio","family":"Franco","sequence":"first","affiliation":[{"name":"Neuromuscular and Sense Organs Department, Eye Clinic, Careggi University Hospital, 50139 Florence, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6629-0712","authenticated-orcid":false,"given":"Federica","family":"Serino","sequence":"additional","affiliation":[{"name":"Neuromuscular and Sense Organs Department, Eye Clinic, Careggi University Hospital, 50139 Florence, Italy"},{"name":"Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, 50139 Florence, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabrizio","family":"Giansanti","sequence":"additional","affiliation":[{"name":"Neuromuscular and Sense Organs Department, Eye Clinic, Careggi University Hospital, 50139 Florence, Italy"},{"name":"Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, 50139 Florence, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,11,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Bar-David, L., and Blumenthal, E.Z. (2018). Evolution of Glaucoma Surgery in the Last 25 Years. Rambam Maimonides Med. J., 9.","DOI":"10.5041\/RMMJ.10345"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"3202","DOI":"10.1038\/s41433-021-01595-x","article-title":"Conventional glaucoma implants and the new MIGS devices: A comprehensive review of current options and future directions","volume":"35","author":"Pereira","year":"2021","journal-title":"Eye"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1007\/BF00166608","article-title":"Conjunctiva and subconjunctival tissue in primary open-angle glaucoma after long-term topical treatment: An immunohistochemical and ultrastructural study","volume":"233","author":"Nuzzi","year":"1995","journal-title":"Graefes Arch. Clin. Exp. Ophthalmol."},{"key":"ref_4","unstructured":"Ong, J.A., Wu, P., and Ahmed, I.I.K. (2020, January 27). Outcomes of ab interno gelatin microstent with MMC using targeted supra-Tenon\u2019s placement. Proceedings of the American Glaucoma Society Annual Meeting, Washington, DC, USA."},{"key":"ref_5","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_6","first-page":"935","article-title":"Impact of Primary Needling on the XEN Implant Clinical Outcomes: A Real-Life Retrospective Study","volume":"28","year":"2022","journal-title":"Clin. Ophthalmol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"685","DOI":"10.2147\/OPTH.S195457","article-title":"Recommendations for the management of elevated intraocular pressure due to bleb fibrosis after XEN gel stent implantation","volume":"18","author":"Vera","year":"2019","journal-title":"Clin. 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Sci."},{"key":"ref_14","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_15","first-page":"6674505","article-title":"Choroidal Detachment after XEN Gel Stent Implantation","volume":"6","author":"Cutolo","year":"2021","journal-title":"J. Ophthalmol."}],"container-title":["Vision"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2411-5150\/7\/4\/71\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T21:16:14Z","timestamp":1760130974000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2411-5150\/7\/4\/71"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,2]]},"references-count":15,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2023,12]]}},"alternative-id":["vision7040071"],"URL":"https:\/\/doi.org\/10.3390\/vision7040071","relation":{},"ISSN":["2411-5150"],"issn-type":[{"type":"electronic","value":"2411-5150"}],"subject":[],"published":{"date-parts":[[2023,11,2]]}}}