Authors: Sébastien Gagné, Darana Yuen, Shawn Cohen
Author Disclosure Block: S. Gagné: None. D. Yuen: None. S. Cohen: None.

Abstract Body:

Purpose: The purpose of this study is to describe and evaluate efficacy and safety of an ab externo implantation (closed conjonctiva) of the (XEN) gel microstent perfomed at the slit lamp (SLX : slit lamp XEN).
Study Design: Retrospective chart review
Methods: Retrospective, multicentric review of charts of patients with uncontrolled glaucoma after receiving maximal tolerated medical therapy (MTMT) who underwent ab externo implantation of the XEN gel microstent performed at the slit lamp. Success rate of implantation (as defined as proper placement of the XEN from the subconjonctival space to the anterior chamber), changes in mean IOP, number of glaucoma medication, anti-metabolite usage and adverse events were analyzed at day 1, 7, 30, month 3 and 6 following SLX
Results: Twenty-nine (29) eyes of twenty-five (25) patients were included in the study. 13 patients received MMC (0.2mg/ml 0.1ml) and 16 patients received 5-FU (50mg/ml 0.1ml). Success rate of implantation was 93.1% (27/29) after one attempt, and 100% (29/29) after a second attempt. Mean baseline IOP was 24.9 +/- 7.5mmHg on 3.2 +/- 0.9 glaucoma medication. At 6 months, mean IOP was significantly reduced from baseline to 13.7 +/- 2.7mmHg (P < 0.016) and 0.1 glaucoma medication. No serious adverse events were reported.
Conclusions: Slit lamp ab externo implantation of the XEN gel microstent (SLX) is safe and effective in lowering IOP in patients with uncontrolled glaucoma. Office based MIGS as performed with SLX is the first glaucoma surgery not to rely on an operating room.