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This abstract is assigned to session AOB Free Papers 2

Presentation type	Oral presentation
Title	XEN® 63 Versus XEN® 45 Gel Stent in Open-Angle Glaucoma: A 5-year follow-up study

Purpose	To compare the long-term efficacy and safety of XEN® 63 Gel Stent (XEN63) versus XEN® 45 Gel Stent (XEN45) in open-angle glaucoma.
Methods	A retrospective (age, gender, diagnosis and pre-operative intraocular pressure (IOP)) matched case–control study at University Hospitals UZ Leuven was conducted, including patients with primary open-angle, pigmentary, or pseudoexfoliative glaucoma that underwent XEN63 or XEN45 implantation between January 2014 and January 2021. Baseline characteristics, IOP, use of topical medication, surgical interventions, and safety outcomes were extracted from medical records and assessed at predefined intervals.
Results	A total of 30 eyes from 30 patients were included: 15 XEN63 and 15 XEN45. Baseline characteristics did not differ between groups. The IOP remained significantly lower in the XEN63 group up to 1 year (difference -5.4 mmHg CI 95% -1.5 to -9.3; p = 0.009). Five-year mean IOP appeared comparable (difference -0.64 mmHg CI 95% -5.1 to 3.8; p = 0.7), although missing data precluded definitive conclusions. Postoperative hypotony occurred more in the XEN63 group compared to XEN45 (13 vs 5; p = 0.008) group, with symptomatic hypotony in, respectively, 6 vs 2 (p = 0.2). The XEN45 group required more needling procedures (7 vs 1; p = 0.04) and secondary glaucoma surgeries (6 vs 1; p = 0.08) compared to the XEN63 group.
Conclusion	Both XEN63 and XEN45 provided sustained IOP reduction over 5 years. XEN63 achieved greater pressure lowering with fewer secondary procedures but was associated with a higher incidence of early hypotony. These findings suggest that XEN63 may offer superior long-term IOP control, provided that postoperative hypotony is carefully managed.
Conflict of interest	No

Authors 1

Initials	T
Last name	Jacobs
Department	KU/UZ Leuven
City	Leuven

Authors 2

Initials	J
Last name	Jan Van Eijgen
Department	KU/UZ Leuven
City	Leuven

Authors 3

Initials	I
Last name	Ingeborg Stalmans
Department	KU/UZ Leuven
City	Leuven