EXPERIENCE IN THE USE OF THE EXPRESS DEVICE WITHOUT MYTOMICIN C IN PATIENTS WITH PRIMARY OPEN ANGLE GLAUCOMA

Abstract

Purpose: To evaluate the efficacy in the control of the intraocular pressure (IOP) with the Express device without the use of Mytomicin C in patients with Primary Open Angle Glaucoma (POAG).

Methods: Prospective, cross sectional and experimental study. 23 eyes of 22 patients with diagnosis of POAG were included. The diagnosis of POAG was made by means of complete ophthalmological examination which included slit lamp examination, IOP meassurement by Goldmann Tonometry, 24-2 Sita standard Visual fields, and optical coherente tomography of the optic nerve and nerve fiber layer analysis. Device implantation was performed by conventional trabeculectomy technique with no use of Mytomicin C. Posterior to the surgery all patients were treated with topical steroids and antibiotic. The IOP was meassured the first and third day post surgery and then every week on first month and then monthly until sixth month. Bleb caractheristics and complications were also evaluated as well as complementary procedures needed.

Results: 23 eyes (22 patients) 4 male and 18 female. Mean age was 66 years. Mean basal tonometry was 17.21 mmHg and mean final IOP 13.82 mmHg. Postsurgical complications included Seidel in seven patients (30.43%) , flat anterior chamber and choroidal detachment was found in two patients (8.69%). One patient had surgical failure who required maximal topical medication (4.34%). Ten patients (43.47%) required needling with 5 fluorouracil aplication. We found conjunctival retraction in one patient (4.34)%) that did not required and additional procedure.

Conclusions: The Express device is usefull in the surgical management in patients with POAG because low complications incidence was obtained as well as good IOP control. Larger population of patients should be evaluated to obtain more concluding results.

Keywords: 568 intraocular pressure • 633 outflow: trabecular meshwork