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Review
. 2015 Aug;24(6):410-6.
doi: 10.1097/IJG.0000000000000047.

Standard Trabeculectomy and Ex-PRESS Miniature Glaucoma Shunt: A Comparative Study and Literature Review

Elad Moisseiev  1 , Eran Zunz, Rotem Tzur, Shimon Kurtz, Gabi Shemesh
Affiliations
Review

Standard Trabeculectomy and Ex-PRESS Miniature Glaucoma Shunt: A Comparative Study and Literature Review

Elad Moisseiev et al. J Glaucoma. 2015 Aug.

Abstract

Purpose: The aim of this study was to compare the efficacy and safety between standard trabeculectomy and the Ex-PRESS shunt implantation.

Methods: A retrospective review of the records of 100 eyes of 100 patients who underwent trabeculectomy or Ex-PRESS shunt implantation between July 2010 and June 2012 was conducted. Of these, 61 (61%) eyes underwent trabeculectomy and 39 (39%) eyes underwent Ex-PRESS shunt implantation. Demographic information, glaucoma type, surgical details, preoperative, and postoperative data including intraocular pressure (IOP), number of medications, reoperation, and occurrence of any complications were recorded.

Results: No differences in IOP reduction or number of postoperative IOP-lowering medications were demonstrated between the 2 procedures. Success rates were 86.9% for trabeculectomy and 84.6% for Ex-PRESS shunt. Rates of failure and hypotony were not significantly different between the groups. No parameter was correlated with success or failure of any procedure.

Conclusions: Standard trabeculectomy and Ex-PRESS shunt have similar efficacy and safety profiles. As the Ex-PRESS shunt is considerably more expensive, its use may be unjustified, especially as a primary procedure.

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Conflict of interest statement

Disclosure: The authors declare no conflict of interest.

Figures

FIGURE 1
FIGURE 1
A comparison of the postoperative IOP (A) and number of IOP-lowering medications in use (B) over 6 months between patients who underwent trabeculectomy and Ex-PRESS miniature glaucoma shunt implantation. No significant difference was demonstrated. IOP indicates intraocular pressure.
FIGURE 2
FIGURE 2
A comparison of the postoperative IOP (A) and number of IOP-lowering medications in use (B) over 6 months between patients who underwent trabeculectomy and Ex-PRESS miniature glaucoma shunt implantation, excluding those who had undergone previous trabeculectomy before inclusion in this study. No significant difference was demonstrated. IOP indicates intraocular pressure.
FIGURE 3
FIGURE 3
Kaplan-Meier product-limit estimate of the survival of trabeculectomy and Ex-PRESS shunt. No significant difference was demonstrated between the 2 procedures.
See this image and copyright information in PMC

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