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Natalie Juárez Reyna, Ana Karina Fabre Miranda, Luis Zarate, Magdalena García-Huerta, Rafael Castaneda Diez, Mauricio Turati Acosta, Jesus Jimenez-Roman, ; The Ex-PRESS glaucoma shunt versus trabeculectomy in open-angle glaucoma in Mexican patients. Invest. Ophthalmol. Vis. Sci. 2014;55(13):3168.
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Compare the efficacy and safety of the EX-PRESS(®) glaucoma filtration device vs trabeculectomy in patients with primary open-angle glaucoma. Intraocular pressure control, the need for additional medical or surgical treatment, complications and changes in vision were studied.
We carried out a retrospective, case series analysis of all patients with ExPRESS filtration device implantation and compared the results with a similar group of patients with trabeculectomy.
24 eyes, 11 (57.8%) in the Express group and 13 (68.4%) in the trabeculectomy group; with a median follow-up of 12 months. Mean age 58.54 years (46-80). Postoperative intraocular pressure reduction was significant in both groups (p 0.0439). Mean intraocular pressure at last control was 15 mmHg (+-4.6) (95% CI 13.3-17.2). Express group 13mmHg (+-2.6) (95% CI 11.1-14.8) and trabeculectomy group 16mmHg (+-5.4) (95% CI 13.3-19.3). . There was a similar number of postoperative interventions and complications for each group 8 (72.73%) vs 10 (76.93%). (P 0.095). The most frequent post-surgical procedures in the Express group were needling 3 (12%), 5-fluorouracil subconjunctival injection 3 (12%) and suturolisis 2 (8%). The most frequent in the trabeculectomy group were bevacizumab subconjunctival injection 7(17%), suturolysis 6 (14%) and needling 5 (12). The most common complications in the Express group were bleb leaks 5 (20%) tube iris contact 4 (16%) and flat anterior chamber 2 (8%) and in the trabeculectomy group were: bleb leaks 6 (14%) and flat anterior chamber 4 (10%). Topical medications to maintain target IOP were required by most of the eyes but the number of medication needed at the last exploration were lower in the Express group 1.5 vs 3.3 in the trabeculectomy. Visual acuity remained unchanged in both groups
The EX-PRESS glaucoma filtration device is as effective and safe as trabeculectomy for patients with primary open-angle glaucoma.
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