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05) except at postoperative 6 months when the outcomes were significantly better (p 0.05) in the ab externo group. The rate of postoperative procedures (5-Fluorouracil injections and bleb needling), the incidence of numerical or clinical hypotony and adverse events were comparable in both groups (p 0.05). The mean number of IOP-lowering medications was comparable in both groups at all time points. The Xen gel stent, whether implanted ab interno or ab externo, is effective in reducing IOP and dependence on topical medications in