Advertisement

PentaVision

Glaucoma Physician

Article | 2026 American Glaucoma Society Meeting

Xen Study Finds Ab Interno and Externo Approaches Equally Effective

Researchers from the University of Illinois College of Medicine found that both approaches reduce IOP, lower medications, and improve visual acuity.

By: Evan Lagouros, MD, Cecilia Canizela, BS
Glaucoma Physician February 23, 2026
Objective:

To evaluate the long-term outcomes of ab interno and ab externo surgical approaches using the Xen gel stent in glaucoma patients.

Key Findings:
  • Both ab interno and ab externo approaches effectively reduced intraocular pressure (IOP).
  • Both approaches led to a decrease in the number of medications required.
  • There was equivalent improvement in best-corrected visual acuity (BCVA) between the two methods.
  • No statistically significant difference was found between the two approaches at any time point up to 3 years.
Interpretation:

The findings suggest that both surgical techniques are equally effective for managing glaucoma, allowing surgeons to choose based on personal preference.

Limitations:
  • The study is retrospective, which may introduce biases.
  • Long-term outcomes beyond 3 years were not assessed.
Conclusion:

Surgeons can confidently use either ab interno or ab externo approaches for Xen gel stent surgery, as both yield similar outcomes in glaucoma management.