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Abstract #28135 Published in IGR 13-1
Combined Ex-PRESS LR-50/IOL implantation in modified deep sclerectomy plus phacoemulsification for glaucoma associated with cataract
Gindroz F; Roy S; Mermoud A; Schnyder CCEuropean Journal of Ophthalmology 2011; 21: 12-19
PURPOSE. This is a prospective study reporting on modified deep sclerectomy (DS) using the Ex-PRESS LR-50 in combined cataract and glaucoma surgery. METHODS. Twenty-four eyes of 24 patients with medically uncontrolled glaucoma underwent modified DS. After phacoemulsification and intraocular lens implantation, the Ex-PRESS LR-50 was inserted into the anterior chamber under a scleral flap. A partial posterior DS was performed to provide an intrascleral bleb. The complete success rate was intraocular pressure (IOP) without medication (less-than or equal to) 18 mmHg; the qualified success rate was IOP (less-than or equal to)18 mmHg with or without medication. Postoperative bleb management (subconjunctival mitomycin C injections (plus or minus) needling) was performed in case of postoperative hypertension or bleb fibrosis. RESULTS. Follow-up was 40.1(plus or minus)10.8 (mean (plus or minus) SD) months. Preoperatively, IOP was 18.1(plus or minus)5.3 mmHg, best-corrected visual acuity (BCVA) was 0.6(plus or minus)0.3, and number of medications was 2.3(plus or minus)1.1. The IOP decreased by 25.4% at 24 months and by 27.0% at 48 months. At 24 months, 19 patients (86.3%) achieved a BCVA of 0.5 or better, and at 48 months the mean BCVA was 0.7(plus or minus)0.3. At the last visit, the mean number of medications was 0.6(plus or minus)0.8 (p<0.05). The complete and qualified success rates were 45.6% and 85.2%. Mitomycin C injections were performed in 5 eyes. No conjunctival erosions over the Ex-PRESS LR-50 were seen. CONCLUSIONS. The Ex-PRESS LR-50 inserted into the anterior chamber after modified DS efficiently lowers IOP in combined surgery, preventing conjunctival erosion, a significant complication when using this device without scleral flap coverage.
S. Roy. Hopital Ophtalmique Jules Gonin, Av. de France 15, CH-1004 Lausanne, Switzerland. sylvain.roy@epfl.ch
Classification:
12.8.2 With tube implant or other drainage devices (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
12.8.3 Non-perforating (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
12.8.10 Woundhealing antifibrosis (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
