SynthesisEye (London, England)2023
Complications and post-operative interventions in XEN45 gel stent implantation in the treatment of open angle glaucoma-a systematic review and meta-analysis.
Synthesis in Eye (London, England), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 11 citations in OpenAlex.
- Minimally Invasive Bleb Surgery for Glaucoma: A Health Technology Assessment.Ontario health technology assessment series · 2024Pooled it
- Predicting bleb revision after XEN gel stent surgery in a real-world open-angle glaucoma cohort.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2026Article
- Three-Year Outcomes and Safety of the XEN63 Gel Stent: A Multicenter Prospective Study in Primary Open-Angle Glaucoma.Journal of clinical medicine · 2026Article
- Update on XEN Gel Stent: A Narrative Review on Indications, Surgical Technique, and Postoperative Management.Ophthalmology and therapy · 2026Review
- [Trabecular, suprachoroidal and subconjunctival innovative glaucoma surgery : S1 guidelines of the German Society of Ophthalmology (DOG) and the German Professional Association of Ophthalmologists (BVA)].Die Ophthalmologie · 2026Review
- The Efficacy and Safety of Minimally Invasive Glaucoma Surgery for Primary Open-Angle Glaucoma: A Systematic Review.Healthcare (Basel, Switzerland) · 2026Review
- Incidence and risk factors for early transient intraocular pressure elevation after penetrating canaloplasty in patients with glaucoma.BMC ophthalmology · 2025Article
- Efficacy and Safety of XEN63 Gel Stent Implant over 6 Months for Treatment of Glaucoma.Journal of clinical medicine · 2025Article
- Xen-DS: a novel technique of ab externo Xen implantation augmented with a modified deep sclerectomy for surgical treatment of glaucoma.Eye (London, England) · 2024Article
- Complications Following XEN45 Gel Stent and Glaucoma Drainage Device Implantation During Glaucoma Fellowship.Cureus · 2024Article
- Recent Advancements in Glaucoma Surgery-A Review.Bioengineering (Basel, Switzerland) · 2023Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe XEN45 Gel Stent is a subconjunctival filtering device that has demonstrated promising efficacy. This meta-analysis quantitatively evaluates reported complications and interventions after XEN45 implantation in the treatment of open angle glaucoma (OAG).
methodsPilot, cohort, observational studies, and randomised controlled trials that included at least ten patients undergoing ab interno or externo XEN45 surgery, with or without phacoemulsification were deemed eligible for inclusion. A meta-analysis of proportions with random-effect models was performed using the meta routine in R version 3.2.1. Outcomes included the rate of complications and post-operative interventions.
resultsOne hundred and fifty-two studies were identified on initial literature search and 33 were included in final analysis. Numerical hypotony was the most common post-operative complication, involving 20% of patients (95% CI: 10-31%). Post-operative gross hyphema occurred in 14% (95% CI: 7-22%) and transient intra-ocular pressure (IOP) spikes (>30 mmHg) in 13% (95% CI: 4-27%). Stent exposure occurred in 1% (95% CI: 0-2%). Stent migration occurred in 1% (95% CI: 0-3%). XEN45 revision and/or a second XEN45 implantation was performed in 5% of patients (95% CI: 3-7%). Stent relocation was performed in 3% (95% CI: 1-7%). A second glaucoma procedure was performed in 11% (95% CI: 8-15%). 26% underwent one (95% CI: 17-36%), 13% underwent two (95% CI: 5-24%) while 4% underwent three (95% CI: 2-6%) bleb needling procedures. 35% of patients (95% CI: 29-40%) required at least one needling. The average rate of needling per patient was 0.38 (95% CI: 0.20-0.59). However, there is a lack of high-quality data, with 8 of the 33 studies assessed to have a moderate to high risk of bias.
conclusionsWhile literature suggests that XEN45 Gel Stent implantation is safe in the treatment of OAG, the overall current level of evidence is low and further studies are needed. More than a third of patients require at least one post-operative bleb needling procedure.
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