Evaluation of Ex-PRESS implantation combined with phacoemulsification in primary angle-closure glaucoma

Abstract

To evaluate the safety and efficacy of Ex-PRESS (R50) implantation combined with phacoemulsification in primary angle-closure glaucoma (PACG) patients with cataract.Twenty-four eyes of 24 patients with unregulated PACG underwent combined cataract and glaucoma surgery. After phacoemulsification and intraocular lens implantation, the Ex-PRESS (R-50) was inserted into the anterior chamber under a scleral flap. The intraocular pressure (IOP), best corrected visual acuity (BCVA), number of medications, and complications were recorded preoperatively as well as postoperatively on day 7 and at 1, 3, 6, and 12 months.The mean follow-up was 16.4 ± 2.5 months (range 14-21 months) and the mean age of the patients was 64.7 ± 6.8 years (range 56-78 years). The mean IOP was 20.4 ± 5.4 mm Hg preoperatively and decreased to 10.2 ± 2.8, 13.1 ± 2.7, 14.9 ± 4.1, 14.3 ± 3.9, and 14.0 ± 3.6 mm Hg on day 7 and at 1, 3, 6, and 12 months after surgery (all P < 0.005). At 12 months, the mean BCVA was 0.62 ± 0.33 and the number of medications was 0.3 ± 0.6. Most of complications were resolved spontaneously and conservatively.The Ex-PRESS implantation combined with phacoemulsification cataract extraction is safe and effective for reducing IOP and antiglaucoma medications in PACG patients with cataract.

Figure 1

Mean IOP before surgery and at each follow-up period. The bars represent the standard deviation. d = day, IOP = intraocular pressure, m = month, Pre = preoperative IOP.

Figure 2

Mean number of glaucoma medications before surgery and at each follow-up period. The bars represent the standard deviation. d = day, m = month, Pre = preoperative number of antiglaucoma medications.

Figure 3

Kaplan–Meier survival analysis.