Purchase this article with an account.
M. Reyes, S. R. Sarkisian; P200 Express Shunt Implantation in Neovascular Glaucoma, Uveitic Glaucoma and Primary Open Angle Glaucoma. Invest. Ophthalmol. Vis. Sci. 2010;51(13):4438.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To study the efficacy in lowering intraocular pressure and the complication profile of the EX-PRESS Mini Glaucoma Shunt, P-200 model, placed under a partial-thickness scleral flap in patients with various types of glaucoma (primary open angle, neovascular, uveitic, multiple mechanism, pigmentary, steroid response, pseudoexfoliation, aphakic, traumatic, chronic angle closure, and ICE syndrome).
A non-comparative cases series was performed at the Dean McGee Eye Institute, University of Oklahoma. 94 eyes of 88 patients underwent Ex-PRESS implantation under a scleral flap with Mitomycin C alone (77 eyes) or combined with cataract surgery (17 eyes). The implantations were performed between the years 2007 and 2009. Post-operative intraocular pressure readings and complications were recorded, as well as addition of medications to further control pressure.
Sixty four (68%) of total implanted eyes were diagnosed with secondary glaucoma. Mean follow up available for all patients was 9.6 months ±6.9 months. For all groups the IOP was reduced from a mean baseline IOP of 31.5 ±13.7mmHg (Mean ± Std) to 14.0 ±7.2 mmHg at 12 months (p<0.001) and 14.7 ±9.8mmHg at the last follow up visit (p<0.001). The average IOP reduction was greater than 40% at each time point of follow up. Medications for all patients were reduced from 3.1±1.1 (Mean± Std) to 0.3±0.7 at 12 months (p<0.001) and 0.3±0.8 at the last follow up visit (p<0.001).Complications: Including all patients there were 4 cases of hyphema, 2 cases of hypotony with choroidals with one of those patients having a shallow anterior chamber. All of these complications spontaneously resolved.Failure: 2 patients required a GDD (1 NVG patient), 4 patients required CPC (all NVG patients), 2 patients required bleb revisions (removal of the mini shunt in one patient), 1 patient required an autologous blood injection, and 1 patient required endocyclophotocoagulation.Success rate: At the last follow-up visit 86% of patients had an IOP≤21mmHg with or without medications and 73% of patients were with no medications.
The Ex-PRESS is safe and effective when used in glaucoma patients with high risk for failure.
This PDF is available to Subscribers Only