Update on XEN Gel Stent: A Narrative Review on Indications, Surgical Technique, and Postoperative Management

Despite topical ocular hypotensive treatment and selective laser trabeculoplasty being the preferred first-line treatment modalities for lowering intraocular pressure, many patients require surgery for further controlling glaucoma progression. The XEN stent is a surgical device designed for the management of glaucoma where previous medical treatments have failed, offering greater predictability and fewer vision-threatening complications compared to trabeculectomy or tube shunts. This comprehensive and narrative review aims to assess different aspects related to XEN implant, including its efficacy, patient profile, surgical technique, and the identification of potential predictors of clinical outcomes. Additionally, this paper describes the most frequently reported adverse events associated with the XEN implant, with the objective of reducing their incidence through a comprehensive understanding of their underlying pathophysiology. Moreover, the authors draw on both existing literature and their clinical experience to provide recommendations for the optimization of the use of this implant.