Abstract
The Xen gel stent is a minimally invasive glaucoma surgical implant designed to decrease intraocular pressure by creating an aqueous outflow path into the subconjunctival space. Since FDA approval, it has demonstrated good safety and efficacy data, however there are multiple reports of Xen stent occlusions with debris from the anterior chamber. Herein, we report a case of a Descemet's membrane Xen stent occlusion in a 67-year-old woman with past medical history of primary open angle glaucoma who underwent Xen stent placement via the ab externo approach. Her Descemet's membrane occlusion was successfully managed by Nd:YAG laser lysis. While uncommon, small Descemet's tears or flaps can occlude the ostia of Xen stents causing elevated intraocular pressure or bleb failure. Few reports have described the use of Nd:YAG laser to successfully treat ostium occlusion of any kind with the Xen stent. We discuss the importance of early Nd:YAG laser to relieve Descemet's membrane occlusions, lower intraocular pressure, and rescue the bleb from failure.
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