Microinvasive Glaucoma Surgery

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Microinvasive Glaucoma Surgery


What keeps the eye inflated is fluid under pressure continually produced inside the eye. At the same time this fluid drains out of the eye through barriers and collector channels into veins surrounding the eye ball. In glaucoma, the flow of fluid through this system becomes obstructed and the pressure start to rise inside the eye. This pressure rise will eventually cause damage to certain sensitive structures within the eye leading to loss of field of vision and eventual blindness if left untreated.

What is the treatment for Glaucoma?

Eye drops are the standard treatment of glaucoma that will reduce eye pressure by either reducing fluid production or improving the flow of fluid out of the eye.  There are times when the eye drops stop producing the desired effects either through the deterioration of glaucoma, too many side effects or poor compliance with the drops regimen.  In such cases some other form of treatment may be required.  The next options for treatment are either Laser or Surgery. Laser may not be suitable for all eyes and usually the effects are short lived.  Surgery is usually more effective.  Traditional surgical techniques are highly invasive and the risks involved are very high.  New Microinvasive techniques have evolved to minimise the surgical trauma and complications.

 Microinvasive Glaucoma Surgery (MIGS)

A group of relatively new surgical techniques that utilizes devices and stents to produce microshunts for eye fluid to drain through.  The XEN Gel Stent is one such device that is suitable for mild to moderate cases of glaucoma.

What is XEN Gel Stent?

Is a soft collagen polymer shaped into a tube and inserted into the eye to shunt the fluid from inside the eye to the outer coats of the eye, bypassing the blockage of fluid flow. The tube is made of collagen derived gelatine that is crosslinked with glutaraldehyde.  This material has been used extensively for other medical purposes.  It is well tolerated by the human body and is non-inflammatory.  The cylindrical implant is 6 mm long and has an inner lumen of 45 µm.   The tube is rigid when dry outside the body.  Once inserted in situ, it quickly hydrates and turns into a gel conforming to the surrounding eye tissue.  This is particularly important for minimal distortion to the eye, erosion of surrounding tissue and gives it stability from extrusion.  This device bypasses the natural drainage pathway and hence suitable for many kinds of glaucoma.

Insertion of the XEN Gel Stent

The procedure is quick, takes only 15—20 minutes and it gives rapid results.  It is inserted through a tiny self-sealing incision using a simple preloaded injector and hence minimal trauma to the eye.  The procedure is done under eye drops as day surgery & the recovery is very rapid with vision returning to normality within a week.

What are the advantages of the XEN Gel Stent?

  • Produces significant and sustained reduction in eye pressure.
  • Suitable for most kinds of glaucoma
  • Minimally invasive.
  • Relatively rapid procedure
  • The soft gel minimises complications
  • Rapid recovery
  • Low risk of infection and complication


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“There is no better way to thank God for your sight than by giving a helping hand to someone in the dark”.   Helen Keller


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