The following is the summary of “Acute Necrotizing Retinopathy After Xen Gel Stent Implantation,” published in the May 2023 issue of Journal of Glaucoma by Lo, et al.
A case of serous retinal detachment, hypotony, and retinal necrosis following implantation of a Xen gel stent in a 45-year-old woman is presented here. A 45-year-old woman developed sudden blurring of vision 4 days after Xen gel stent replacement surgery. Medical and surgical interventions were unsuccessful in stopping the rapid progression of persistent hypotony, uveitis, and severe retinal detachment. Within 2 months, they become completely blind due to retinal necrosis, optic atrophy, and blindness. Culture and blood test results were negative, ruling out infectious and autoimmune-related uveitis; however, acute postoperative infectious endophthalmitis could not be ruled out.
However, mitomycin-C-related toxic retinopathy was eventually suspected. There has been a rise in the popularity of minimally invasive glaucoma surgeries. Patients with mild to moderate glaucoma have succeeded with the Xen gel stent (Allergan), a hydrophilic tube made of porcine gelatin crosslinked with glutaraldehyde that facilitates drainage of aqueous fluid from the anterior chamber into the subconjunctival space. Some complications have been reported after surgery, ranging from mild ones like transient hypotony and increased intraocular pressure (IOP) to more serious ones like hypotony maculopathy, retinal vein occlusion, endophthalmitis, and a shallow anterior chamber.