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A 59-year-old male with a history of diabetes mellitus and bilateral primary open angle glaucoma was referred to our clinic due to uncontrolled intraocular pressure (IOP) in the right eye. On examination, the visual acuity was 20/20 in both eyes and IOP was measured 22 mmHg in his right eye and 14 mmHg in his left eye despite maximal medical treatment. The patient had undergone two trabeculectomy and an EX-Press shunt surgery in the right eye previously. XEN gel stent (Allergan, Dublin, CA) implanted in the inferonasal quadrant due to the scarring in superior and nasal conjunctiva as a result of failed surgeries. The patient was followed up for 18 months with an IOP under 10 mmHg without any medication or a second intervention. XEN stent implantation may be considered as an effective option where other surgical techniques failed, and the conjunctiva is unsuitable in the superior quadrant.

Inferonasal XEN gel stent implantation in a refractory glaucoma patient with failed multiple glaucoma filtration surgeries: Case report