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L.A. De Jong; Ex–PRESSTM Positioned Under a Scleral Flap, Trabeculectomy and ExPRESSTM Positioned Under Conjunctiva in Patients With Open Angle Glaucoma. A Prospective Comparison Randomized 3–Arms Study . Invest. Ophthalmol. Vis. Sci. 2005;46(13):68.
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Purpose: to assess whether implantation of ExPRESS under a scleral flap (USF) is more effective compared to Trabeculectomy (Trab.) and to the Ex–PRESS implanted under the conjunctiva (UCT) in patients with open angle glaucoma (OAG) who failed medical treatment and are indicated for glaucoma surgery. Methods: 120 naïve eyes of 109 OAG patients were randomly assigned to either USF, Trab. or UCT surgical treatment. Complete eye examination was done prior to the operation, on the 1st and 7th days, and 1st, 3rd, 6th postoperative months. Success rate, IOP and use of IOP–lowering medications were compared. Results: Mean patient’s age was 61.8±13.3 years (USF), 68.7±11.5 years (Trab.) and 61.8±13.3 years (UCT). Follow–up period ranged between 1 to 26 weeks in all groups. Mean IOP 6 months post–op was 14.9, 13.4 and 13.4 mmHg in the USF, Trab. and UCT (31.3, 26.5 and 37.6% reduction) respectively. Mean number of medications was reduced by 90, 90 and 80% for the USF, Trab. and UCT, respectively. The complete success rate in last visit was 84%, 69% and 57% for USF, Trab. and UCT, and the overall success rate was 88%, 75% and 67% respectively. Conclusions: USF Implantation of the Ex–PRESS is more effective than Trab. in terms of % IOP reduction and medication reduction.
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