Abstract
Purpose::
Our purpose was to evaluate the clinical outcomes of the Ex-PRESS miniature glaucoma device placed under a partial-thickness scleral flap.
Methods::
This was a retrospective, non-comparative case series. Patients with glaucoma not controlled with maximal medical therapy were treated with the Ex-PRESS implant (Optonol Ltd, Neve Ilan, Israel) under a scleral flap. Success was defined as intraocular pressure (IOP) between 5 and 21 mmHg with or without additional medication, and without further glaucoma surgery.
Results::
In this series, 300 eyes were consecutively treated with mean follow-up period of 17 months (range 3 to 36 months). The mean ± SD pre-operative IOP was 25.5 ± 10.3 mmHg, which was reduced to 14.7 ± 7.1 mmHg at 6 months (P < 0.001), 15.2 ± 7.9 mmHg at 9 months (P < 0.001), and 15.2 ± 7.9 at 1 year (P < 0.001) postoperatively. The number of glaucoma medications was significantly reduced during the postoperative period. The success rate was 89.0 % at 6 months, 87.3% at 9 months, and 84.9% at 1 year postoperatively. No erosion of the conjunctiva over the device occurred in this series. Five patients (1.7%) developed obstruction of the lumen of the Ex-PRESS implant, which was successfully treated with the Nd:YAG laser.
Conclusions::
The Ex-PRESS miniature glaucoma device implanted under a scleral flap was safe and effective. Blockage of the lumen of the device in a small proportion of patients was treated with the Nd:YAG laser.
Keywords: clinical (human) or epidemiologic studies: outcomes/complications • wound healing • anterior chamber