Laser Iridoplasty to Treat Iris-occluded XEN Gel Stent

Abanoob F. Tadrosse, Albert S. Khouri

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


Purpose:To provide the first report on argon laser peripheral iridoplasty (ALPI) to restore XEN-45 Gel stent patency after iris occlusion.Methods:Case description, laser technique, and relevant clinical imaging.Results:A 53-year-old African American male patient presented with progressive advanced stage primary open-angle glaucoma. Initial intraocular pressure (IOP) was 40 mm Hg, which continued to be elevated despite maximal medical therapy and selective laser trabeculoplasty. The patient underwent an uncomplicated XEN-45 Gel stent implantation and presented with an IOP of 4 mm Hg 5 days postoperatively with a functioning bleb. On postoperative day 10, the XEN lumen was found to be occluded by the iris with an IOP spike of 39 mm Hg. Anti-glaucoma treatment to induce miosis and liberate the stent was unsuccessful. ALPI was attempted to relieve the obstruction. IOP dropped to 26 mm Hg immediately post-ALPI and continued to be well-controlled 6 months later (11 mm Hg).Conclusions:ALPI can effectively restore XEN Gel stent patency if occluded by the iris and should be considered before attempting more invasive surgical revisions.

Original languageEnglish (US)
Pages (from-to)E91-E92
JournalJournal of Glaucoma
Issue number8
StatePublished - Aug 1 2020

All Science Journal Classification (ASJC) codes

  • Ophthalmology


  • XEN-45 Gel stent
  • argon peripheral laser iridoplasty
  • complication management
  • iris occlusion


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