Management of Nonfiltrating XEN Gel Stent

In this glaucoma surgical video, Dr. Somar Hasan manages a nonfiltrating XEN gel stent during open revision using a 10-0 nylon suture. After opening the conjunctiva and exposing the sclera, the surgeon carefully dissects and removes the scar around the tissue, taking care not to damage the implant. To restore filtration, it is important to perform multilayer dissection and remove even very thin scar layers and membranes. If this does not help correct the implant, pressure on the globe or increasing IOP with BSS may trigger filtration. When Dr. Hasan faces a nonfunctioning stent, he opens the lumen of the implant using a 10-0 nylon filament suture. Pushing the monofilament inside the implant until it reaches the anterior chamber and then removing it has an immediate effect on opening the stent and restoring filtration.

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