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. 2011:5:1063-6.
doi: 10.2147/OPTH.S23129. Epub 2011 Jul 29.

The first report on intermediate-term outcome of Ex-PRESS glaucoma filtration device implanted under scleral flap in Japanese patients

Tetsuya Sugiyama  1 , Maho Shibata, Shota Kojima, Mari Ueki, Tsunehiko Ikeda
Affiliations

The first report on intermediate-term outcome of Ex-PRESS glaucoma filtration device implanted under scleral flap in Japanese patients

Tetsuya Sugiyama et al. Clin Ophthalmol. 2011.

Abstract

Purpose: This paper compares the outcomes of the Ex-PRESS(®) Glaucoma Filtration Device (Alcon, Fort Worth, TX) implant observed in Japanese patients for 1 year with those of patients undergoing trabeculectomy.

Patients and methods: The subjects comprised ten eyes of ten cases with open-angle glaucoma for which filtration surgery using Ex-PRESS (P-50) was performed by one operator from February 2008 and observed for at least 1 year (Ex-PRESS Group), and eleven eyes of eleven cases for which trabeculectomy was performed by the same operator (TE Group). For both groups, mitomycin C was used and a scleral flap was created after a fornix-based incision of the conjunctiva.

Results: Hypotony and choroidal detachment were observed as early postoperative complications during a 1-week period in one-third of the cases in the TE Group, and failing vision in about 45%, while these were seen in fewer cases in the Ex-PRESS Group. No significant difference in intraocular pressure (IOP) was observed during the period, but IOP variations on the day following the surgery were obviously narrower in the Ex-PRESS Group than in the TE Group. Visual acuity was significantly poorer from 1 week to 3 months in the TE Group while it was stable in the Ex-PRESS Group. The Ex-PRESS Group had fewer cases of laser suture lysis and fewer administrations of glaucoma eyedrop, and no cases of progression in the stage of visual field defect.

Conclusion: Filtration surgery using the Ex-PRESS is unlikely to cause early complications in Japanese patients. Similarly to the trabeculectomy, the intermediate-term control of IOP showed favorable results.

Keywords: Ex-PRESS; Japanese; complication; efficacy; miniature glaucoma device.

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Figures

Figure 1
Figure 1
Time-course trends in intraocular pressure (IOP) of the Ex-PRESS Group and the conventional trabeculectomy (TE) Group. Notes: Data are expressed as mean ± SEM for ten and eleven eyes, respectively. There was no significant difference between the groups at any time-point (unpaired t-test).
Figure 2
Figure 2
Kaplan–Meier survival analysis after implantation of the Ex-PRESS device under a scleral flap (Ex-PRESS Group, solid line) or conventional trabeculectomy (TE Group, dashed line). The success rate was 100% (Ex-PRESS Group) and 81.8% (TE Group) at 1 year postoperatively (P = 0.167, log-rank test).
Figure 3
Figure 3
Time-course trends in visual acuity of the Ex-PRESS Group (•) and the conventional trabeculectomy (TE) Group (○) excluding cases with additional cataract surgery. Notes: Data are expressed as mean ± SEM for seven and eight eyes, respectively. Each asterisk indicates a significant difference compared with preoperative level (*P < 0.05, paired t-test).
See this image and copyright information in PMC

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