Express Shunt Under a Scleral Flap as Primary Surgical Treatment for Open Angle Glaucomas

Abstract

Purpose: : To evaluate the efficacy of the Express Shunt underneath a scleral flap without Mitomycin C as primary surgical therapy in open angle glaucomas.

Methods: : Retrospective Chart Review of patients who received glaucoma filtration surgery at a Veterans Administration Hospital using the Express Shunt underneath a scleral flap.

Results: : 26 eyes of 24 patients who received the Express Shunt underneath a scleral flap as the primary surgical therapy for open angle glaucomas had their pre operative, 1 day, 1 week, and 3 month intraocular pressures (IOP) evaluated and recorded. Mean pre operative IOP was 22. Mean 1 day post op IOP was 7, 1 week IOP was 12, 3 month IOP was 18. Pre operative and 3 month post operative visual acuities were recorded and found to be unchanged. Approximately 55% of patients needed to resume at least one medication to control intraocular pressure 3 months after their surgical procedure.

Conclusions: : The Express Shunt underneath a scleral flap may prove to be a useful option in terms of primary surgical therapy for open angle glaucomas. Further evaluation is warranted. Surgical success could likely be improved upon with the use of adjunct antifibrotic agents.

Keywords: wound healing • anterior chamber • sclera