Posters

ExPRESS shunt implantation with phacoemulsification for management of chronic angle-closure glaucoma

Poster Details

First Author: K.Nabil Elsayed Ghazal SAUDI ARABIA

Co Author(s):    A. Samir   A. Elsayed   A. Lotfy              

Abstract Details

Purpose:

to evaluate the safety and efficacy of combined phacoemulsification and ExPress mini shunt implantation for the surgical management of chronic angel closure glaucoma

Setting:

retrospective non randomized study including 17 eyes of 17 patients done in Magrabi Eye Hospital, Jeddah Saudi Arabia

Methods:

After phacoemulsification and intraocular lens implantation, the Ex-PRESS mini shunt  was inserted into the anterior chamber under a scleral flap.In all eyes before inserting the shunt we did  peripheral iridectomy using a 23 gauge vitrectomy probe in the site of ExPress shunt insertion to create a space for the shunt and prevent iris touch in such narro angels.Postoperative follow up parameters were intraocular pressure (IOP), best corrected visual acuity (BCVA), number of medications, and complications on day 7 and at  3, 6, and 12 months

Results:

The mean follow-up was 12.4 ± 4.5 months (range 14–18 months) and the mean age of the patients was 55.7 ± 6.8 years . The mean IOP was 24.4 ± 4.4 mm Hg preoperatively and decreased to 12.2 ± 2.8, 12.1 ± 2.7, 12.5 ± 3.1,  and 14.9 ± 4.5 mm Hg on day 7 1 month,  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. No reported cases of hypotony. all cases were manipulated by laser suturlysis in different times in the postoperative period.

Conclusions:

The Ex-PRESS implantation combined with phacoemulsification  is safe and effective for reducing IOP in patient with chronic angel closure glaucoma. Adding a peripheral iredectomy in the site of ExPress shunt implantation avoid iris touch and chaving with creation of more space for the shunt.

Financial Disclosure:

None