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Sarwat Salim, Sumalee Boonyaleephan, Jim Wan, Haiming Du; Surgical Outcomes of the Ex-PRESS Glaucoma Filtration Device in African American and Caucasian Glaucoma Patients. Invest. Ophthalmol. Vis. Sci. 2012;53(14):3735.
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To compare the surgical outcomes of the Ex-PRESS glaucoma filtration device in African American and Caucasian glaucoma patients.
This was a retrospective comparative case series of 36 eyes of 36 African Americans and 43 eyes of 43 Caucasians that underwent placement of the Ex-PRESS glaucoma filtration device under a partial-thickness scleral flap for uncontrolled glaucoma. All eyes received intraoperative mitomycin C. The primary outcome measures were intraocular pressure (IOP), number of postoperative glaucoma medications, and surgical success. Surgical success was defined as IOP between 5 and 18 mmHg, with or without glaucoma medications, without further glaucoma surgery, or loss of light perception vision.
Average follow-up was 30 (range, 13-46) months. At 33 months, surgical success was 80.0% in the African American group and 83.3% in the Caucasian group (P=1.00). Reasons for surgical failure included increased IOP (3 eyes, 3.8%), persistent hypotony with maculopathy (1 eye, 1.3%), and further surgery (4 eyes, 5.06%). Compared with preoperative values, the mean postoperative IOP and number of glaucoma medications were significantly reduced in both groups and no statistical difference was observed between the 2 groups at 33 months. Postoperative complications were similar in the 2 groups.
Similar surgical outcomes were observed in African American and Caucasian glaucoma patients after implantation of the Ex-PRESS glaucoma filtration device. This latest modification of glaucoma filtration surgery may be a better surgical option for African Americans given its potential advantages of no tissue removal, predictable outcomes related to consistent lumen size and controlled flow, fewer postoperative complications, and overall reduced inflammation.
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