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Failed Needling After XEN in a Case of POAG

  Channels: Glaucoma | Posted 2/20/2019

Arsham Sheybani, MD, presents a case of failed needling after XEN Gel Stent (Allergan) implantation. A 52-year-old African-American man presented with severe primary open-angle glaucoma and an IOP of 20 mm Hg on four classes of medication with poor compliance. The patient underwent implantation of XEN with the use of 60 mcg of mitomycin C; the stent was slightly curled following placement. At month 2 his postoperative IOP was 22 mm Hg without medication. The bleb was flat, and the XEN was scarred and slightly more curled. Needling was performed with a 27-gauge needle using 20 mcg MMC, but the IOP did not come down, and the XEN Gel Stent could not be straightened. Four classes of medication were restarted, and at month 4 his postoperative IOP was 17 mm Hg.

Arsham Sheybani, MD • Mitomycin C, MMC • Needling • Open Angle Glaucoma • XEN

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