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Meng Lu, Michelle Pham, Irena Cherfas, Robert D. Fechtner; Retrospective Efficacy Comparison of Ex-PRESS Miniature Glaucoma Implant with Trabeculectomy. Invest. Ophthalmol. Vis. Sci. 2011;52(14):633.
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Retrospectively compare the long-term efficacy of the Ex-PRESS mini glaucoma shunt with that of standard trabeculectomy.
In this retrospective chart review, data were collected for 2 groups of patients: Group A (n=31) had undergone Ex-PRESS implants under scleral flap and Group B (n=29) standard trabeculectomy by a single surgeon. All surgeries had follow-up of at least 12 month. Data collected included baseline and post-operative intraocular pressure (IOP), glaucoma medication use, visual acuity, and recorded complications. Data from four examinations were collected during the first 3 month after the procedures and additional data collected at 3-6 month intervals thereafter. Data are reported up to month 18 post-operatively.
In Group A 23 eyes had primary open angle glaucoma, 5 pseudoexfoliation, and 3 juvenile glaucoma. Mean follow up was 26 month +/- 12.9. In Group B 23 eyes had primary open angle glaucoma, 2 pseudoexfoliation, 1 steroid induced glaucoma, and 3 chronic angle closure. Mean follow up was 27.8 month +/- 12.6. There were no statistically significant differences between Group A and B baseline IOP and glaucoma drop use. Baseline, post-operative IOPs and glaucoma drop use are shown in the table below.
During the early post-operative period (post-op day 1 and postop week 1) eyes implanted with Ex-PRESS had lower IOP compared with eyes that underwent trabeculectomy. However by post-operative week 4, IOP reduction was not significantly different with follow up to 18 months. Complications and need for IOP lowering medications did not differ.
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