This case study reports the successful implantation of the Xen ab interno gel stent in a 44-year-old man with refractory chronic open-angle glaucoma. The patient had multiple unsuccessful filtration surgeries including a trabeculectomy and 2 Ahmed glaucoma valves placed superotemporally and inferonasally oculus dexter. The patients intraocular pressure was reduced from 29 mm Hg preoperatively to 17 mm Hg 1 year after surgery, without any ocular complications. The Xen gel stent may be considered as a possible intervention to lower intraocular pressure in patients with refractory glaucoma, despite previous filtration surgeries if the superonasal conjunctiva is spared and healthy.