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Hirofumi Uyama, Takanori Kameda, Yasuhiko Hirami, Fumitaka Hirose, Akihiro Nishida, Kazuhiro Ishida, Yasuo Kurimoto; Investigation of Ex-PRESS Device placement after Ex-PRESS Glaucoma Filtration Device Surgery using Anterior Segment Optical Coherence Tomography. Invest. Ophthalmol. Vis. Sci. 2014;55(13):3169.
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© ARVO (1962-2015); The Authors (2016-present)
To quantify device position after Ex-PRESS® (Alcon) glaucoma filtration surgery using anterior segment optical coherence tomography (AS-OCT).
This study included 62 eyes of 52 glaucoma patients who underwent Ex-PRESS® filtration device surgery by 6 surgeons between August 2012 and April 2013. All eyes received the Ex-PRESS® P-50 under scleral flap into anterior chamber. To quantify the device and surrounding structures, we scanned eyes using AS-OCT, CASIA® (SS-1000, TOMEY) postoperatively. To quantify the device position, we measured the length between tip of the device and the inner corneal surface and the angle between the device and the inner corneal surface. We also analyzed the contact between the device and the iris, and the occlusion of two openings (tip and reserve openings) of the device in anterior chamber.
AS-OCT provided the images of contour of the Ex-PRESS device. Lengths between tip of the device and inner corneal surface were 0.83 ± 0.40 mm (range, 0 to 1.56 mm). The angles between device and inner corneal surface were 40.7 ± 11.8 degrees (range, 14 to 60 degrees). The length significantly correlated with the angle (P < 0.001). In 14 out of 62 eyes (27%), the device had contact with the iris. The angles were significantly larger in eyes with contact between the device and the iris than in eyes without contact (P = 0.02). In 55 eyes (89%), two openings of the device were successfully located in anterior chamber. One opening of the device was occluded in 5 eyes (8%), and two openings were occluded in 2 eyes (3%), which were embedded in corneal stroma.
AS-OCT provides images of the device after Ex-PRESS® device surgery. AS-OCT is a useful tool to assess the position of the device. Optimizing device position would decrease the rate of complications of the surgery.
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