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. 2012:6:955-62.
doi: 10.2147/OPTH.S32282. Epub 2012 Jun 22.

Surgical outcomes of the Ex-PRESS glaucoma filtration device in African American and white glaucoma patients

Sarwat Salim  1 , Haiming Du, Sumalee Boonyaleephan, Jim Wan
Affiliations

Surgical outcomes of the Ex-PRESS glaucoma filtration device in African American and white glaucoma patients

Sarwat Salim et al. Clin Ophthalmol. 2012.

Abstract

Purpose: To compare the surgical outcomes of the Ex-PRESS glaucoma filtration device in African American and white glaucoma patients.

Design: Retrospective comparative case series.

Methods: This was a comparative case series of 36 eyes of 36 African Americans and 43 eyes of 43 whites that underwent placement of the Ex-PRESS glaucoma filtration device under a partial-thickness scleral flap for uncontrolled glaucoma. All eyes received intraoperative mitomycin C. The primary outcome measures were intraocular pressure (IOP), number of postoperative glaucoma medications, and surgical success. Surgical success was defined as IOP between 5 and 18 mm Hg, with or without glaucoma medications, without further glaucoma surgery, or loss of light perception vision.

Results: Average follow-up was 31.9 ± 9.8 (range, 14.6-47) months for African Americans and 30.7 ± 8.6 (range, 14.3-47) months for whites. At 33 months, surgical success was 80.0% in the African American group and 83.3% in the white group (P = 1.00). Reasons for surgical failure included increased IOP (3 eyes, 3.8%), persistent hypotony with maculopathy (1 eye, 1.3%), and further surgery (4 eyes, 5.06%). Compared with preoperative values, the mean postoperative IOP and number of glaucoma medications were significantly reduced in both groups, and no statistical difference was observed between the two groups at 33 months. Postoperative complications were similar in the two groups.

Conclusions: Similar surgical outcomes were observed in African American and white glaucoma patients after implantation of the Ex-PRESS glaucoma filtration device. This latest modification of glaucoma filtration surgery may be a better surgical option for African Americans given its potential advantages of no tissue removal, predictable outcomes related to consistent lumen size and controlled flow, fewer postoperative complications, and overall reduced inflammation.

Keywords: African American; Ex-PRESS glaucoma filtration device; White; antimetabolites; glaucoma; trabeculectomy.

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Figures

Figure 1
Figure 1
Mean intraocular pressure (IOP) after implantation of Ex-PRESS in African Americans and whites. Note: *P ≤ 0.05.
Figure 2
Figure 2
Mean number of glaucoma medications after implantation of Ex-PRESS in African Americans and whites. Note: *P ≤ 0.05.
Figure 3
Figure 3
Kaplan–Meier survival analysis after implantation of Ex-PRESS glaucoma filtration device in African American and white glaucoma patients.
See this image and copyright information in PMC

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