Recently approved by the FDA and now covered by Medicare, the XEN is a tiny gelatin tube inserted through the wall of the eye to drain fluid and reduce the eye pressure. It is indicated for almost any type of glaucoma and can be done as a separate procedure or combined with cataract surgery. Once medical and laser glaucoma treatments fail to control glaucoma, we as glaucoma surgeons recommend surgery to lower the eye pressure. For patients with earlier stage glaucoma, minimally invasive surgical procedures in the angle of the eye, usually combined with cataract surgery, may be sufficient to control their disease. But for those with more severe or advanced disease, a much more invasive and riskier procedure such as trabeculectomy is indicated.
XEN is the first glaucoma device that may offer similarly high effectiveness with less risk. It is a minimally invasive procedure, it usually takes only several minutes to perform, and the recovery is much quicker than with standard glaucoma surgery, such as trabeculectomy.
In my opinion, the XEN gel stent is an excellent option for patients with more advanced stages of glaucoma. We are learning quickly from our own experiences and from our glaucoma colleagues around the country on how this procedure can benefit patients. I believe it will greatly reduce the need for us to perform more invasive trabeculectomy and tube shunt procedures.
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Ilya Rozenbaum, MD