biostudies-literatureUnknown264(1)Ventura-Abreu NFundació Institució dels Centres de Recerca de Catalunya<h4>Purpose</h4>To characterize bleb morphology and conjunctival features after XEN45 Gel Stent surgery (XGS) using slit-lamp bleb grading, anterior segment optical coherence tomography (AS-OCT), in vivo confocal microscopy (IVCM), and impression cytology analysis (ICA), in both success and failure cases.<h4>Methods</h4>Twenty-four eyes (24 patients) underwent XGS, with 20 included in the final analysis. In addition to a full ophthalmic exam, blebs were evaluated using Moorfield's Bleb Grading System (BGS), AS-OCT, IVCM, and ICA. AS-OCT metrics included bleb-wall and subepithelial cyst-like structure area and density (BECSA/BECSD, BSCSA/BSCSD), bleb height (BH), bleb thickness (BT), and epithelial thickness (BET). IVCM parameters included stromal meshwork reflectivity (SMR), goblet cell deGraefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie207-218https://www.ebi.ac.uk/biostudies/studies/S-EPMC12906558biostudies-literatureLongitudinal analysis of XEN45 gel stent bleb morphology using bleb grading scales, anterior segment-OCT, in vivo confocal microscopy, and impression cytology.PMC12906558Molins BVentura-Abreu NPorto SPazos MGuerra-Meniconi JLabay-Tejado SMuniesa MJMilla EfalseLongitudinal analysis of XEN45 gel stent bleb morphology using bleb grading scales, anterior segment-OCT, in vivo confocal microscopy, and impression cytology.<h4>Purpose</h4>To characterize bleb morphology and conjunctival features after XEN45 Gel Stent surgery (XGS) using slit-lamp bleb grading, anterior segment optical coherence tomography (AS-OCT), in vivo confocal microscopy (IVCM), and impression cytology analysis (ICA), in both success and failure cases.<h4>Methods</h4>Twenty-four eyes (24 patients) underwent XGS, with 20 included in the final analysis. In addition to a full ophthalmic exam, blebs were evaluated using Moorfield's Bleb Grading System (BGS), AS-OCT, IVCM, and ICA. AS-OCT metrics included bleb-wall and subepithelial cyst-like structure area and density (BECSA/BECSD, BSCSA/BSCSD), bleb height (BH), bleb thickness (BT), and epithelial thickness (BET). IVCM parameters included stromal meshwork reflectivity (SMR), goblet cell de2026-01-01T00:00:00Z2026 Jan2026-07-15T21:23:04.55Z2026-07-09T10:13:37.902ZS-EPMC129065584104236110.1007/s00417-025-06952-0