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Sarwat Salim, Jim Wan, Haiming Du; Comparison of Surgical Outcomes of the Ex-PRESS Glaucoma Filtration Device with Mitomycin C in Phakic and Pseudophakic Eyes. Invest. Ophthalmol. Vis. Sci. 2013;54(15):4758.
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To compare the surgical outcomes of the Ex-PRESS glaucoma filtration device with mitomycin C in phakic and pseudophakic eyes.
This was a retrospective comparative case series of 76 eyes (40 phakic eyes and 36 pseudophakic eyes) that underwent placement of the Ex-PRESS glaucoma filtration device under a partial-thickness scleral flap for uncontrolled glaucoma. All pseudophakic eyes had prior clear-corneal phacoemulsification. All eyes received intraoperative mitomycin C at the time of Ex-PRESS implantation. The primary outcome measures were intraocular pressure, number of postoperative glaucoma medications, and surgical success. Surgical success was defined as intraocular pressure between 5 and 18 mmHg, with or without glaucoma medications, and without further glaucoma surgery or loss of light perception vision. Secondary outcome measures were intraoperative and postoperative complications.
Average follow-up was 32.3 ± 7.9 (range, 15-47) months for phakic eyes and 29.0 ± 8.8 (range, 14.3-47) months for pseudophakic eyes. No significant difference was observed between phakic and pseudophakic eyes in mean intraocular pressure, change from baseline intraocular pressure, or adjunctive use of glaucoma medications at 33 months follow-up. Surgical success by Kaplan-Meier survival analysis at 33 months was 80.00% for phakic eyes and 80.65% for pseudophakic eyes (P = 0.94). Reasons for surgical failure included increased IOP (three eyes, 3.9%), persistent hypotony with maculopathy (one eye, 1.3%), and further surgery (four eyes, 5.3%).
Surgical outcomes after insertion of the Ex-PRESS glaucoma filtration device were similar in phakic and pseudophakic eyes after prior clear-corneal phacoemulsification
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