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Abstract #11727 Published in IGR 7-1
Implantation of a miniature glaucoma device under a scleral flap
Dahan E; Carmichael TRJournal of Glaucoma 2005; 14: 98-102
See also comment(s) by Richard Lewis •
PURPOSE: To test the safety and efficacy of the Ex-PRESS miniature glaucoma device when it is implanted under a scleral flap instead of under the conjunctiva as it was originally suggested. PATIENTS AND METHODS: Between November 2000 and February 2003, the Ex-PRESS implant was inserted in 24 eyes of 23 patients with severe open angle glaucoma. Sixteen eyes of the 24 (66%) had had previous failed filtering surgery. The remaining 8 eyes (33%) were high risk for failures cases. A 5 x 5 mm limbal-based, 50% depth, scleral flap was raised into clear cornea. The Ex-PRESS implant was inserted into the anterior chamber under the scleral flap at the limbus. The scleral flap was securely sutured back, as is done in trabeculectomy operations. RESULTS: The intraocular pressure was significantly reduced from 27.2 ± 7.1 mmHg pre-operatively to 14.5 ± 5.0 mmHg at 12 months (n = 21) and 14.2 ± 4.2 mmHg at 24 months (n = 8). Postoperatively, only two patients needed anti-glaucoma medications to keep the IOP below 21 mmHg. CONCLUSIONS: The Ex-PRESS device was found to be safe and effective with few complications when it is implanted under a scleral flap even in the high-risk patients studied.
Dr. E. Dahan, Department of Ophthalmology, University of the Witwatersrand, Johannesburg, South Africa. dahaneli@mweb.co.za
Classification:
12.8.2 With tube implant or other drainage devices (Part of: 12 Surgical treatment > 12.8 Filtering surgery)