What is glaucoma?

Glaucoma is a series of eye diseases that can damage the optic nerve and ultimately impair vision. The main risk factor that can be treated is an increased intraocular pressure. However, today, glaucoma is not understood as a mere „pressure disorder“ but as a multifactorial disease. The two most important risk factors for glaucoma are increased intraocular pressure and deviation from normal perfusion of the optic nerve and retina. Both factors can only be assessed in an ophthalmological examination!

There are a number of other glaucoma risk factors, such as:

  • Older:
    Older people are more likely to get sick than young people.
  • Genetic load:
    Glaucoma disorders in the family increase the risk.
  • Higher myopia:
    Myopes from minus 5 diopters have a higher risk of glaucoma
  • Corneal thickness:
    Too thin, but also too strong a cornea can falsify the measurement of intraocular pressure.
  • MMigraine and sleep apnea syndrome (snoring):
    These conditions often indicate glaucoma disease.
  • Underlying diseases such as Atherosclerosis, diabetes mellitus, elevated or too low blood pressure.

Glaucoma and intraocular pressure

Intraocular pressure comes about through the production and outflow of the so-called aqueous humor. This is formed in the ciliary body. Part of the aqueous humor is released into the vitreous humor. The greater part flows from the posterior chamber of the eye into the anterior chamber of the eye and finally through Schlemm’s canal.

For a stable and healthy intraocular pressure, it is important that the same amount of aqueous humor can flow away as it is formed. In the most common form of glaucoma (open angle glaucoma), the outflow of aqueous humor from the eye is disturbed. This increases the pressure on the eye.

What tasks does the aqueous humor have?

The aqueous humor has two important functions: on the one hand it serves to supply the non-perfused internal structures of the eye (eg lens, cornea).

The second important function of aqueous humor is the balance between aqueous humor production and aqueous humor discharge. Thus, in the intraocular pressure creates a pressure, the so-called intraocular pressure. If the outflow of aqueous humor is disturbed, the pressure in the eye increases steadily and can subsequently damage the optic nerve. In this case, a therapy is indicated.

Darstellung Augeninnendruck

An open-angle glaucoma usually arises when the outflow of aqueous humor is disturbed and therefore the intraocular pressure increases. Due to the increased intraocular pressure, the optic nerve is damaged.

What treatment options are there?

For the treatment of glaucoma, there are currently a number of forms of treatment.

The first goal of the treatment is always the reduction of the increased intraocular pressure.

The most common treatment for primary open-angle glaucoma is the use of hypotensive eye drops. For many years, different laser techniques have been used. With low efficacy or intolerance of eye drops and the laser treatment surgical procedures are used. These include inter alia trabeculectomy, viscocanaloplasty, but also drainage implants, such as the XEN implant described below.

The most common cause of failure of surgical therapy is the blockage of drainage from scarring at the surgical site. The intraocular pressure can not be reduced to the expected, low value. However, it may also result in undesirable complications during surgery or after surgery, such as bleeding, low intraocular pressure, a shallow anterior chamber or changes in visual acuity.

Each patient will be informed before the start of treatment about the effects, possible adverse effects and side effects of the drugs used and the risk of complications of various surgical procedures.

How does the XEN gel implant work?

The XEN gel implant is a medical device for the treatment of primary open-angle glaucoma. It is a small tube implanted between the anterior chamber of the eye and the conjunctiva. Excess aqueous humor drains from the anterior chamber of the eye via this tube, thus reducing intraocular pressure.

XEN-Gel-Implant implantiert

The XEN gel implant delivers the aqueous humor from the anterior chamber under the conjunctiva, where it is transported away by blood and lymphatic vessels.

What’s the Benefit of Having an XEN Gel Implant Surgery?

The XEN Gel Implanat has been designed to work as a microscopic delivery system to dissipate the excess fluid produced in the eye.

The XEN gel implant consists of cross-linked gelatin, which is generally well accepted by ocular tissue. The gelatin has the special property of expanding on contact with aqueous material. When the XEN gel implant is inserted into the eye, the outer diameter of the implant expands. This expansion of the outer diameter of the implant helps to maintain it at its intended position after surgical implantation.

The special surgical approach from the inside (from interno) is less invasive. The natural drainage channels remain in the conjunctiva. By minimizing conjunctival damage, the possibility of a renewed glaucoma intervention usually remains.

The goal of XEN gel implantation is to improve or even stop the progression of your primary open angle glaucoma. The new ejaculation reduces intraocular pressure, reducing the damage to the optic nerve caused by increased intraocular pressure. Also, the number of intraocular pressure lowering medications that you are currently taking can be reduced or even eliminated.

Are there any risks and side effects?

Each procedure involves potential risks. Since the implantation procedure is conceptually less traumatic (hurting), there is usually only minimal damage to eye structures.

If you use the microimplant with lens surgery, there is the benefit of a single operation with just one anesthetic. In this case, you will be informed separately about the risks of the implant and the risks of lens surgery.

However, complications may occur during or after the procedure, as with all surgical procedures. Possible complications include temporary and minor side effects as well as impaired vision. This could potentially include: procedural discomfort, increase or decrease in intraocular pressure, inflammation of the eye, bleeding into the eye, loss of vision, injury or penetration of the superficial white conjunctiva, corneal damage or cataract (clouding of the eye lens). The implant itself could cause an allergic reaction or move out of alignment.

Additional intake of medicines?

You can continue taking medications that you normally take. However, medication may be adjusted to lower intraocular pressure.