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J Glaucoma. 2009 Aug;18(6):488-91. doi: 10.1097/IJG.0b013e31818fb44e.

Ex-PRESS miniature glaucoma device implanted under a scleral flap alone or combined with phacoemulsification cataract surgery.

Author information

1
Department of Ophthalmology, Hamilton Eye Institute, University of Tennessee Health Science Center, Memphis, TN 38163, USA.

Abstract

PURPOSE:

Our purpose was to evaluate the clinical outcomes of the Ex-PRESS miniature glaucoma device placed under a partial-thickness scleral flap as a single procedure or combined with phacoemulsification cataract surgery.

METHODS:

This was a comparative consecutive case series of 345 eyes: 231 eyes treated with Ex-PRESS implant under scleral flap alone and 114 eyes treated with Ex-PRESS implant under scleral flap combined with phacoemulsification (both groups were treated intraoperatively with mitomycin C).

RESULTS:

The patients were followed for 25.7+/-11.1 (range, 1 to 46.2) months (Ex-PRESS alone) and 21.9+/-12.5 (range, 1.9 to 46.2) months (combined cases). At 3 years after surgery, surgical success was 94.8% and 95.6% in the Ex-PRESS and combined groups, respectively (P=0.948). Compared with baseline values, the postoperative intraocular pressure (IOP) and number of glaucoma medications were significantly lowered in both groups. The change from baseline IOP was significantly greater after Ex-PRESS implant alone compared with combined surgery (P<0.001). The most common device-related complication was obstruction of the tube (6 eyes), which was treated successfully with Nd:YAG laser in all 6 eyes.

CONCLUSIONS:

The use of the Ex-PRESS implant under a scleral flap was effective for lowering IOP both alone and combined with cataract surgery. The most common device-related complication was tube blockage, which was treated with the Nd:YAG laser.

PMID:
19223790
DOI:
10.1097/IJG.0b013e31818fb44e
[Indexed for MEDLINE]

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