Abstract
Purpose: :
To evaluate the short term safety and efficacy of P200 Ex-PRESS shunts versus P50 shunt.
Methods: :
A retrospective chart review, evaluating patients who underwent a P50 or P200 Ex-PRESS shunt was conducted. Patients having express shunt implant, express shunt combined with cataract extraction, as well as patients who had previous glaucoma surgery were included. Patients with uveitic glaucoma, neovascular glaucoma or less than 3 months of follow up were excluded. Postoperative data including intraocular pressure (IOP), number of glaucoma medications and surgery related complications was collected.
Results: :
60 eyes with the P50 Ex-PRESS shunt (Group 1) and 23 eyes with the P200 Ex-PRESS shunt (Group 2) were evaluated. Average age was 72.3 +/- 13.2 years for Group 1 and 71.0 +/- 13.2 years for Group 2. The pre-op IOP was 26.9 +/- 9.3 mmHg for Group 1 and 27.8 +/- 11.5 mmHg for Group 2 (p = 0.73). The pre-op number of medications used were 2.8 +/- 1.4 for Group 1 and 3.30 +/- 1.33 for Group 2 (p = 0.15). At 3 months there was a significant reduction in IOP in both groups; the IOP for Group 1 was 15.8 +/- 8.8 mmHg (p < 0.0001) and 12.8 +/- 6.7 mmHg (p < 0.0001) for Group 2. Additionally, at 3 months there was a significant reduction in number of medications used in both groups. Group 1 used 1.0 +/- 1.6 medications (p < 0.0001) and Group 2 used 0.17 +/- 0.65 medications (p < 0.0001). At 3 months post-op, Group 2 had a 3.81 mmHg +/- 2.96 (p = 0.20; 95% CI -9.63 - 2.01) greater reduction in IOP than Group 1 and used 0.83 +/- 0.35 (p = 0.02; 0.12 to 1.53) fewer medications than Group 1. The rate of early post-op complications in Group 1 and 2 respectively at 3 months were; hypotony (IOP ≤ 5): 5.0% and 8.7% (p = 0.90); endophthalmitis 1.7% (1/60) and 0.0% (p > 0.99). There was no incidence of hyphema in either group.
Conclusions: :
Both the P50 and P200 Ex-PRESS shunts produced a significant reduction in IOP at 3 months. There was no statistical difference in reduction of IOP between the two groups at 3 months, but patients in the P200 group used significantly fewer medications. There was not a high incidence of complications in either group and there was no significant difference between groups with respect to complications.
Keywords: clinical (human) or epidemiologic studies: outcomes/complications • outflow: trabecular meshwork • intraocular pressure