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Meng Lu, Michelle Pham, Irena Cherfas, Tamara Berezina, Amir Cohen, Robert D. Fechtner, Albert Khouri; Comparison of Ex-PRESS Glaucoma Filtration Device with Trabeculectomy in African American Population: 1 Year Results. Invest. Ophthalmol. Vis. Sci. 2012;53(14):3726.
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To compare the IOP-lowering efficacy and need for post-operative interventions in African American patients undergoing Ex-PRESS glaucoma shunt or trabeculectomy.
A retrospective chart review was performed for all patients of African American ethnicity who underwent Ex-PRESS implants under scleral flap (Group A) and trabeculectomy (Group B) between 8/03/2004 and 2/15/2011. All surgery was augmented with intraoperative Mitomycin C. Only subjects with at least 6 months of follow-up were included. Data on intraocular pressure (IOP) and IOP-lowering medication use at baseline and post-op 1m, 3m, 6m, 9m, and 12m, and postoperative interventions including laser suture lysis (LSL) and 5FU injections were collected.
A total of 36 subjects (Group A 21 eyes, Group B 19 eyes) were included. IOP and number of medication reduction from baseline were significant for Groups A and B at all time points. The differences in IOP and number of medication reduction between the two groups were not statistically significant at any time points. Data is summarized in Table 1. The total number of post-operative 5-FU injections were significantly lower in Group A (mean 1.62) than Group B (mean 2.58), (p=0.03). The mean total number of LSL in Groups A and B were similar (A=1.38, B= 1.63, p=0.25).
In this cohort of African American patients the Ex-PRESS shunt was as effective as trabeculectomy in reducing IOP and required similar post-operative IOP-lowering medications. The Ex-PRESS group required less intensity of post-operative intervention.
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