Real-World Twelve-Month Outcomes of Open-Conjunctiva XEN45 Gel Stent Implantation Using Trabeculectomy-Style Perioperative Management

Purpose To analyze 12-month outcomes of XEN open conjunctiva implantation coupled with a “trabeculectomy-style” intraoperative and postoperative management. Methods This retrospective cohort study included consecutive eyes that underwent standalone XEN gel stent implantation by a single surgeon between May 2022 and September 2024. Outcomes included intraocular pressure (IOP), glaucoma medication use, adverse events, and surgical success. Comparisons with baseline were analyzed using paired two-tailed t-tests, and overall success was evaluated using Kaplan–Meier survival analysis. Results Fifty-three eyes of 42 patients were included. Mean IOP decreased by 40% from 21.45 mmHg to 12.86 mmHg at 12 months (p < 0.0001). Mean medication burden decreased by 89%, from 3.17 to 0.34 medications (p < 0.0001). Complication rates were low and no postoperative needling procedures were required. Kaplan-Meier analysis demonstrated a surgical success rate of 88% at 12 months. Conclusions Open conjunctiva XEN gel stent implantation with trabeculectomy-style perioperative management provides effective IOP and medication reduction with low complication and intervention rates.