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Title	Efficacy of ab interno gel stent in open-angle glaucoma 18 to 24 months after implantation: IOP reduction and position within the irido-corneal angle
Abstract Nr.	3011

Purpose	To analyse the intraocular pressure (IOP) reduction and the position of the stent within the irido-corneal (IC) angle 18 to 24 months after Xen45 (Aquesys) subconjunctival implantation.
Methods	63 eyes were implanted with Xen 45 (+MMC) (49 primary open-angle glaucoma, 5 pigmentary, 5 juvenile, 2 pseudoexfoliative, 2 post steroïds). Qualified or complete success was defined as postoperative 5≤IOP≤18mmHg with or without glaucoma medication respectively. Failure were postoperative IOP<5 or >18mmHg, additional glaucoma surgery or implant replacement.
Results	Preoperative IOP was 21.8±6.9mmHg (n=61) on 2.6±1.1 drugs. IOP was reduced to 13.4±2.5mmHg (-38.8%) on 0.6±1.0 (-75.8%) drugs (n=19) after 18 months (p<.0001) and 13.9±1.5mmHg (-36,5%) after 24 months, on 1.3±1.6 (-50.7%) drops (n=7) (p<.0004). Complete success rate at 18 months was 66%, qualified 33% and failure 6%. 47% of blebs were revised. Few early complications occurred. 25.6% of Xen were anterior to Schwalbe line, 28.2% in the trabeculum and 46.2% in the scleral spur. No significant IOP variation was found regarding the Xen position in the IC angle. The aspect of the bleb has varied as flat, diffuse, kystic, ischemic, proximal or distal to the limbus.
Conclusion	Decrease of IOP and the use of glaucoma medications during 24 months of follow-up confirm Xen subconjunctival implantation as a safe, effective and lasting MIGS technique. However, all parameters to predict IOP decrease are not yet established. The Xen position within IC angle could be one, but no significative correlation could be confirmed. The path of the xen through sclera, the bleb distance to limbus and its appearance (kystic, ischemic…) could be other. Future explorations using SA-OCT may help to get more predictable results.
Conflict of interest	No

Authors 1

Last name	MALAISE
Initials	D
Department	CHU Liège
City	Liège

Authors 2

Last name	DUPONT
Initials	G
Department	CHU Liège
City	Liège

Authors 3

Last name	COLLIGNON
Initials	N
Department	CHU Liège
City	Liège