The Barraquer Ophthalmology Centre has started to use micro-invasive techniques for surgical treatment of glaucoma like the Xen implant, and it is achieving excellent results.

We are approaching a new surgical era faced with new MIGS or micro-invasive techniques, whose common denominator is making a minor manipulation to the eye tissue, with maximum safety and efficiency. These are less invasive techniques with lower risks, and cause less discomfort to the patient during the post-operative period as patients can go without stitches.

Glaucoma is defined as an optic nerve disease where damage is irreversible. Its causes are many and the most important risk factor is high intraocular pressure. These are determined, at the same time, by the balance between the speed of aqueous humour production (the intraocular fluid which nourishes the cornea and lens), and its draining resistance and difficulty.

The Xen implant has a 46µm diameter and is 6mm long, made with biocompatible collagen material which, on contact with the eye structures, becomes soft, encouraging so-called aqueous humour filtration. It then restores the balance between the entry and exit of aqueous humour, thereby regulating intraocular pressure. An injector is used to make insertion easier, which can be performed alone, or in combination with the surgical procedure for cataract removal.

At this point the position on the therapeutic scale is very specific, and includes open-angle glaucoma, at an incipient to moderate stage, which could be an alternative to some medical and laser treatments. In advanced stage glaucoma, filtration surgery (deep and non penetrating trabeculectomy, sclerectomy) and the valve drainage device (Ahmed or Baerveldt are the most common) continue to be the techniques of choice.

The capacity to widen the range of surgical possibilities means we can offer more personalised medical care. The micro-invasive technique with the Xen implant looks very promising for glaucoma surgery. Glaucoma control and a better quality of life for our patients is our main aim.

Dr. Maria Isabel Canut