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The Ex-PRESS glaucoma shunt vs non-penetrant deep sclerectomy in open-angle glaucoma: a prospective randomized study and preliminary results
Poster Details
First Author: M.Munoz SPAIN
Co Author(s): A. Anton M. Castany A. Martinez J. Urcelay J. Moreno F. Munoz Negrete
Abstract Details
Purpose:
Express shunt device and deep sclerectomy have been evaluated previously and even when both procedures are effective in reducing intraocular pressure, there are no comparative studies between them.
We performed a prospective, multicenter, randomized trial to evaluate efficacy and safety of combined cataract and filtering surgery with Ex-Press implant versus deep sclerectomy (NPDS) in 12 months follow up.
Setting:
Parc de Salut Mar and Hosp. Vall d'Hebron Barcelona, Hospital Gregorio Marañon and Hospital Ramon y Cajal Madrid, Clínica Universitaria Navarra, Hospital San Eloy Bilbao.
Methods:
This was a prospective, randomized trial. Eyes from enrolled patients were randomly assigned to either Ex-PRESS implantation under a scleral flap, or trabeculectomy. The main outcome measures were: mean intraocular pressure (IOP), postoperative medication use, visual acuity, and incidence of complications. Complete success was defined as an IOP of 4 mmHg and 4 mmHg and
Results:
There were 78 patients (80 eyes) with primary open-angle, pseudoexfoliative, or pigmentary glaucoma enrolled in the study. A total of 84.6% of patients receiving Ex-PRESS and 60.0% of patients receiving trabeculectomy (P=0.0230) achieved complete success. The respective proportions of patients achieving an IOP >4 mmHg and
Conclusions:
In open-angle glaucoma, the Ex-PRESS mini glaucoma shunt implanted under a superficial scleral flap produces significantly higher success rates, and a similar complication rate, compared with trabeculectomy. The Ex-PRESS is a safe and effective device for treating open-angle glaucoma.
Financial Disclosure:
One or more of the authors research is funded, fully or partially, by a company producing, developing or supplying the product or procedure presented