Scleral buckling procedures create a challenge for intraocular pressure (IOP) control in the glaucoma patient. The encircling band is believed to compress vortex veins, causing increased episcleral venous pressure, a proposed mechanism for secondary glaucoma. Glaucoma drainage device implantation is preferred over trabeculectomy when medical management fails, but often involves modification of the glaucoma implant and manipulation of the fibrotic capsule surrounding the scleral buckle. This case demonstrates that ab externo XEN gel stent implantation may successfully reduce IOP without interfering with the previous scleral buckle, a major limitation of previous glaucoma filtering surgeries.
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