Abstract
Purpose :
We compared complications between trabeculectomy and Ex-PRESS implantation following 2 years after operation.
Methods :
Thirty-nine primary open-angle and 25 exfoliation glaucoma eyes were randomly assigned to be treated with trabeculectomy (n=32) or Ex-PRESS implantation (n=32). Twenty-seven male and thirty-seven female patients with mean age 71.7 ± 10.5 years were recruited. The primary outcome was postoperative complications, including cataract progression (assessed by light scattering intensity in nucleus and Lens Opacification Classification System three), decreasing rate of corneal endothelial cell density, intra-ocular pressure, and best-collective visual acuity between trabeculectomy and Ex-PRESS implantation. The secondary outcomes were the comparison of decreasing rate of corneal endothelial cell density among 5 photographing areas (central, superior, inferior, nasal and temporal areas) after surgery and postoperative late complications.
Results :
Trabeculectomy had significantly more nuclear cataract progression in 1 and 2 years (1 year, P=0.02; 2 years, P=0.04) after operation and more postoperative late complications (2 years, P=0.02) than Ex-PRESS implantation did while Ex-PRESS implantation had significantly higher decreasing rate of corneal endothelial cell density than trabeculectomy did. (1 year, P=0.004; 2 years, P=0.026). Corneal endothelial cell density in the superior area was more significantly decreased than that in inferior area. (1 year, P=0.02; 2years, P=0.04).
Conclusions :
Ex-PRESS implantation shows slower progression of nuclear cataract and more loss of corneal endothelial cells than trabeculectomy. Corneal endothelial cells are more lost in the superior area, where the Ex-PRESS tube was implanted, compared to the inferior area.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.