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Abstract #46143 Published in IGR 13-2
Intermediate-term results of the Ex-PRESS miniature glaucoma implant under a scleral flap in previously operated eyes
Lankaranian D; Razeghinejad MR; Prasad A; Fakhraie G; Freitas DJ; Ichhpujani P; Moster MRClinical and Experimental Ophthalmology 2011;
Background: To report the safety and efficacy of Ex-PRESS(TM) miniature glaucoma implant under a scleral flap in patients with previous ocular surgeries. Design: Retrospective, non-comparative case series from a tertiary care hospital. Participants: Patients with previous cataract or failed glaucoma surgeries who had undergone implantation of the Ex-PRESS(TM) miniature glaucoma implant (R-50 and T-50), under a scleral flap, with a minimum of 1-year postoperative follow up. Methods: For postoperative outcome, success was defined as complete if intraocular pressure (IOP) was 5-21mmHg without medication or surgical intervention, and qualified if intraocular pressure was within the same range with glaucoma medication. To compare the outcome between patients who had previous trabeculectomy or cataract surgery the definition of success was intraocular pressure of 5-15mmHg. Main Outcome Measures: Intraocular pressure, number of antiglaucoma drugs, visual acuity and complications. Results: One hundred eyes (100 patients; mean age: 77.4years) with a mean follow-up period of 27(plus or minus)13.2months (range: 12-66) were considered. Success was complete in 60 (60%) and qualified in 24 (24%) eyes. The mean preoperative IOP of 27.7(plus or minus)9.2mmHg (range: 14-52mmHg) with 2.73(plus or minus)1.1 drugs declined to 14.02(plus or minus)5.1 mmHg with 0.72(plus or minus)1.06 drugs at the last follow up (P< 0.0001). Causes of failure were uncontrolled intraocular pressure (11%), bleb needling (4%) and persistent hypotony (1%). The probability of success in the patients with previous cataract surgery and trabeculectomy at 3years was 60.6% and 50.9%, respectively. Conclusions: The Ex-PRESS(TM) implant under scleral flap was a safe and effective glaucoma surgery in the eyes with prior ocular surgery.
M.R. Moster. Glaucoma Service at Wills Eye Institute, 840 Walnut Street, Suite 1130, Philadelphia, PA 19107, United States. Email: marlenemoster@aol.com
Classification:
12.8.2 With tube implant or other drainage devices (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
