Comparison between the EX-PRESS P-50 implant and trabeculectomy in patients with open-angle glaucoma

Mendoza-Mendieta, María Elena; Lopez-Venegas, Ana Paola; Valdés-Casas, Gerardo Eliud

doi:10.2147/opth.s94850

Cited by 14 publications

(13 citation statements)

References 13 publications

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“…In our EX-PRESS group, the surgical success rate was 33.3%, which is much lower than the 80% success rate reported by Mendoza-Mendieta et al [ 16 ] for eyes with primary OAG. In our opinion, this major difference could be due to the previous ocular surgery in the cases in our study.…”

Section: Discussioncontrasting

confidence: 73%

Ahmed Glaucoma Valves versus EX-PRESS Devices in Glaucoma Secondary to Silicone Oil Emulsification

Qian

Kong

et al. 2018

Journal of Ophthalmology

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Objective To evaluate and compare the clinical effects of Ahmed glaucoma valves (AGVs) and EX-PRESS implants on glaucoma secondary to silicone oil (SO) emulsification. Methods A retrospective case-series study was designed. A total of 23 eyes with late intraocular pressure (IOP) elevation secondary to SO emulsification were included in the study. Antiglaucoma surgery with implantation of AGVs or EX-PRESS devices was performed. Pre- and postoperative ocular parameters were recorded at each visit during a 1-year follow-up period. The rates of complete success (IOP < 21 mmHg without medication) and qualified success (IOP < 21 mmHg with ≤3 glaucoma medications) were analyzed. Results A total of 14 eyes underwent AGV implantation, and 9 underwent EX-PRESS implantation. The mean IOP and number of medications used at the last follow-up decreased significantly compared with that before surgery (P < 0.001). The total success rate for all eyes including complete success (7/23) and qualified success (7/23) was 60.9% (14/23) at 1 year. The total success rate in the AGV group was 78.6% (11/14), whereas it was 33.3% (3/9) in the EX-PRESS group; the difference between the 2 groups was significant (P < 0.05). Conclusion For glaucoma secondary to SO emulsification, glaucoma implants could be effective at lowering IOP, and AGVs might produce better outcomes than EX-PRESS devices.

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Section: Discussioncontrasting

confidence: 73%

Ahmed Glaucoma Valves versus EX-PRESS Devices in Glaucoma Secondary to Silicone Oil Emulsification

Qian

Kong

et al. 2018

Journal of Ophthalmology

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“…8 articles were from three cohorts, respectively [5, 7, 9, 12, 13, 15–17], so the most recent three articles were chosen. Thus, 8 RCTs were eligible after a full-text screening [6, 8–14] and were finally included in the meta-analysis. Kappa statistic between the investigations was calculated based on the formula of the Cochrane Handbook for Systematic Reviews of Interventions, and the value was 0.667.…”

Section: Resultsmentioning

confidence: 99%

“…In most studies [7, 9, 11], complete success was defined as IOP 5∼18 mmHg and 20% reduction from the baseline without antiglaucoma medications, while qualified success was the same criteria mentioned above with or without antiglaucoma medications. The difference among other definitions mainly lies in the IOP values irrespective of medication/surgery interventions added or not [8, 10, 14]. Moreover, it was judged that data on success rate by Errico et al [6], Dahan et al [11], and Mendoza–Mendieta et al [14] were incorrect or unextracted, so the above studies were not included for analysis.…”

Section: Discussionmentioning

confidence: 99%

“…The difference among other definitions mainly lies in the IOP values irrespective of medication/surgery interventions added or not [8, 10, 14]. Moreover, it was judged that data on success rate by Errico et al [6], Dahan et al [11], and Mendoza–Mendieta et al [14] were incorrect or unextracted, so the above studies were not included for analysis. But the hazard ratio 0.27 of complete success and 0.21 of qualified success reported by Dahan et al was favorable to EX-PRESS [11].…”

Section: Discussionmentioning

confidence: 99%

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Trabeculectomy and EX-PRESS Implantation in Open-Angle Glaucoma: An Updated Meta-Analysis of Randomized Controlled Trials

Sun

Zhang

Zhou

et al. 2019

Journal of Ophthalmology

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Purpose Accumulating studies comparing the efficacy and safety of trabeculectomy and EX-PRESS implantation in open-angle glaucoma (OAG) report inconsistent findings. Thus, we conducted the updated meta-analysis to clarify the issue. Methods Randomized controlled trials (RCTs) were selected through search of databases PubMed, Web of Science, Embase, and the Cochrane Library from their inception up until November 2018. The pooled mean difference (MD) for intraocular pressure reduction (IOPR) and antiglaucoma medication reduction, odds ratio (OR) for operative success, complication, and postoperative intervention was calculated using the random effects model. Results 8 RCTs were enrolled, including 223 eyes in the EX-PRESS group and 217 eyes in the trabeculectomy group. EX-PRESS device implantation had a better IOPR% at 12 months postoperatively (MD = 8.9, 95% confidence interval (CI) = 2.5–15.3, P=0.006). There was no statistically significant difference in the antiglaucoma medication reduction (MD = 6.01, 95% CI = −4.13–16.15, P=0.25) and qualified success (P > 0.05). Statistically higher complete success at 1 year postoperatively was found in the EX-PRESS group (OR = 3.26, 95% CI = 1.24–8.55, P=0.02). EX-PRESS was associated with a lower frequency of increased IOP (OR = 0.15, 95% CI = 0.03–0.93, P=0.04) and hyphema (OR = 0.20, 95% CI = 0.05–0.74, P=0.02). Less postoperative intervention was needed in the EX-PRESS group (OR = 0.43, 95% CI = 0.20–0.94, P=0.04). Conclusion For OAG patients, EX-PRESS implantation provided better efficacy in IOP control and complete success at 1 year postoperatively, with fewer increased IOP and hyphema as well as postoperative interventions. EX-PRESS device and trabeculectomy were similar in the qualified success and antiglaucoma medication reduction.

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“…By contrast, in the case of neovascular glaucoma, standard trabeculectomy proved better performances as compared to Ex-PRESS. Ex-PRESS shunt interventions differ from one study to another, in terms of what and how frequently, but all patients received mitomycin C as anti-mitotic medication (Table I) [17][18][19][20][21][22][23][24][25][26][27].…”

Section: Introductionmentioning

confidence: 99%

Comparison of Ex-PRESS P-200 mini-shunt implantation and standard trabeculectomy for open-angle glaucoma: four-year follow-up

Nicula

Nicula²,

Rednik

et al. 2019

Arch Med Sci

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Introduction: The study aimed to evaluate the efficacy and safety in 4-year follow-up of ExPRESS P-200 mini-shunt implantation versus standard trabeculectomy. Material and methods: A single-center retrospective study on patients diagnosed with open-angle glaucoma with failed medical treatment and who underwent ExPRESS device implantation or standard trabeculectomy was conducted. Seventy-three eyes were included in the analysis, 33 with ExPRESS P-200 implantation and 40 with standard trabeculectomy. Results: Significant decreases in the intraocular pressure (IOP) were observed after surgery and at all follow-ups in both groups (p < 0.001) with no significant difference between the two groups (p > 0.40). No significant differences with regard to post-operative medications were observed (p > 0.10). Excepting the 3-year follow-up, when just a borderline significant difference regarding the visual acuity between the ExPRESS and standard trabeculectomy group was observed (p = 0.0504), the ExPRESS groups showed significantly better visual acuity at 6 weeks (p = 0.0324), 1 year (p = 0.0168), 2 years (p = 0.0162), and 4 years (p = 0.0111). Hypotony occurred more frequently among the ExPRESS group, while cataract occurred more frequently among those with standard trabeculectomy, without significant differences between groups (p > 0.09). No difference in hazard of failure was observed between interventions (HR = 0.72, p = 0.523). Conclusions: Both procedures provided good control of IOP and decreased the number of postoperative medications. The advantage of the ExPRESS shunt is the better visual acuity, but its main limitation is the cost.

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Comparison between the EX-PRESS P-50 implant and trabeculectomy in patients with open-angle glaucoma

Cited by 14 publications

References 13 publications

Ahmed Glaucoma Valves versus EX-PRESS Devices in Glaucoma Secondary to Silicone Oil Emulsification

Ahmed Glaucoma Valves versus EX-PRESS Devices in Glaucoma Secondary to Silicone Oil Emulsification

Trabeculectomy and EX-PRESS Implantation in Open-Angle Glaucoma: An Updated Meta-Analysis of Randomized Controlled Trials

Comparison of Ex-PRESS P-200 mini-shunt implantation and standard trabeculectomy for open-angle glaucoma: four-year follow-up

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