Giant Papillary Conjunctivitis Induced by Sutures after XEN Stent Implantation

Purpose: We present a case of giant papillary conjunctivitis (GPC) induced by sutures used during XEN gel stent implantation.Case summary: A 67-year-old man underwent XEN gel stent implantation in his right eye for uncontrolled glaucoma. After surgery, intraocular pressure (IOP) was maintained below 15 mmHg. However, eight months postoperatively, the IOP increased to 24 mmHg, and the patient reported a foreign body sensation. The 10-0 nylon suture used during stent implantation was exposed on the conjunctiva, and marked papillary hypertrophy was observed in the upper palpebral conjunctiva. Following removal of the suture material, the papillary hypertrophy resolved, and IOP decreased to 17 mmHg.Conclusions: Retained sutures after glaucoma surgery can induce giant papillary conjunctivitis, and the associated hypertrophy may affect filtration bleb function, leading to elevated IOP. This risk is heightened when devices, such as the XEN stent, are positioned superficially in the subconjunctiva, requiring careful suture management and timely removal.