Comparison of trabeculectomy versus Ex-PRESS: 3-year follow-up

Gonzalez-Rodriguez, Johanna M; Trope, Graham E.; Drori-Wagschal, Lilach; Jinapriya, Delan; Buys, Yvonne M.

doi:10.1136/bjophthalmol-2015-307161

Cited by 50 publications

(51 citation statements)

References 13 publications

(38 reference statements)

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“…In previous analyses using Ex-PRESS, it has been reported that the postoperative IOP after 2 years ranges from 12.1 to 14.7 mmHg. 8 , 11 – 13 Our results were thus slightly lower than those reported previously. This was at least partly due to the greater number of postoperative medications in our patients.…”

Section: Discussioncontrasting

confidence: 95%

“…Many studies have compared conventional trabeculectomy and trabeculectomy with Ex-PRESS. 8 – 11 Ex-PRESS exhibits similar outcomes with fewer early postoperative complications because of its low rate of over-filtration. Other advantages of Ex-PRESS are that the lumen of the device is standardized constantly, and the outflow is predictable.…”

Section: Introductionmentioning

confidence: 96%

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Factors influencing the filtration-bleb volume after Ex-PRESS<sup>®</sup> surgery

Tojo

Hayashi

Otsuka

2018

OPTH

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PurposeThe aim of this study was to investigate the factors influencing the volume of the filtration bleb after Ex-PRESS® surgery.MethodsThis was a retrospective non-randomized study. After excluding patients who had undergone an additional glaucoma surgery, 99 glaucoma patients who underwent Ex-PRESS® surgeries and were followed up for >2 years were analyzed. We used anterior segment optical coherence tomography to measure the bleb volume, and compared the volume at 1 year with that at 2 years after surgery. We also examined potential influencing factors, including age, number of medications, central corneal thickness, type of glaucoma, preoperative intraocular pressure (IOP), postoperative IOP, reduction ratio of IOP, history of trabeculotomy, and operation method (Ex-PRESS® surgery only or simultaneous cataract surgery).ResultsEx-PRESS® surgeries significantly decreased the IOP from 26.3±9.7 mmHg to 11.6±3.7 mmHg after 24 months (P<0.001). The success rate at 2 years was 81.2% (IOP ≥21 mmHg or ≥20% reduction from the baseline IOP). The results showed that age, postoperative IOP, glaucoma type, and simultaneous cataract surgeries influenced the filtration-bleb volume.ConclusionAdvanced age, higher postoperative IOP, pseudo-exfoliation glaucoma, and simultaneous cataract surgeries were all found to decrease the volume of the filtration bleb.

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Section: Discussioncontrasting

confidence: 95%

Section: Introductionmentioning

confidence: 96%

Factors influencing the filtration-bleb volume after Ex-PRESS<sup>®</sup> surgery

Tojo

Hayashi

Otsuka

2018

OPTH

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“…Success rates after trabeculectomy with target pressure between 18 and 22 mmHg have been variously reported to range from 43% to 86% without medications [17–26] and from 59% to 98% with medications [17, 21, 22]. In our study, postoperatively, a complete success was possible in 64.7% with an IOP at final follow-up of <18 mmHg without medication and 82.35% with IOP <18 mmHg with two or less medications.…”

Section: Resultssupporting

confidence: 51%

Stab Incision Glaucoma Surgery: A Modified Guarded Filtration Procedure for Primary Open Angle Glaucoma

Jacob

Figus

Kumar

et al. 2016

Journal of Ophthalmology

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Purpose. To describe a modified guarded filtration surgery, stab incision glaucoma surgery (SIGS), for primary open angle glaucoma (POAG). Methods. This prospective, interventional case series included patients with POAG (IOP ≥21 mmHg with glaucomatous visual field defects). After sliding superior conjunctiva down over limbus, 2.8 mm bevel-up keratome was used to create conjunctival entry and superficial corneoscleral tunnel in a single step starting 1.5 mm behind limbus. Lamellar corneoscleral tunnel was carefully dissected 0.5–1 mm into cornea and anterior chamber (AC) was entered. Kelly Descemet's punch (1 mm) was slid along the tunnel into AC to punch internal lip of the tunnel, thereby compromising it. Patency of ostium was assessed by injecting fluid in AC and visualizing leakage from tunnel. Conjunctival incision alone was sutured. Results. Mean preoperative IOP was 27.41 ± 5.54 mmHg and mean postoperative IOP was 16.47 ± 4.81 mmHg (n = 17). Mean reduction in IOP was 38.81 ± 16.55%. There was significant reduction of IOP (p < 0.000). 64.7% had IOP at final follow-up of <18 mmHg without medication and 82.35% had IOP <18 mmHg with ≤2 medications. No sight threatening complications were encountered. Conclusion. Satisfactory IOP control was noted after SIGS in interim follow-up (14.18 ± 1.88 months).

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“…EXP was developed in an effort to make filtration surgery more straightforward. Nonetheless, it seems that the efficacy and safety profile of the EXP are not superior to standard trabeculectomy [44][45][46][47]. Only a few studies directly comparing AGV and EXP have been published.…”

Section: Ahmed Glaucoma Valve Versus Ex-press Shuntsmentioning

confidence: 99%

A Review of the Ahmed Glaucoma Valve Implant and Comparison with Other Surgical Operations

et al. 2017

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The Ahmed glaucoma valve (AGV) is a popular glaucoma drainage implant used for the control of intraocular pressure in patients with glaucoma. While in the past AGV implantation was reserved for glaucoma patients poorly controlled after one or more filtration procedures, mounting evidence has recently encouraged its use as a primary surgery in selected cases. AGV has been demonstrated to be safe and effective in reducing intraocular pressure in patients with primary or secondary refractory glaucoma. Compared to other glaucoma surgeries, AGV implantation has shown favorable efficacy and safety. The aim of this article is to review the results of studies directly comparing AGV with other surgical procedures in patients with glaucoma.

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Comparison of trabeculectomy versus Ex-PRESS: 3-year follow-up

Abstract: NCT01263561; post results.

Cited by 50 publications

References 13 publications

Factors influencing the filtration-bleb volume after Ex-PRESS<sup>®</sup> surgery

Factors influencing the filtration-bleb volume after Ex-PRESS<sup>®</sup> surgery

Stab Incision Glaucoma Surgery: A Modified Guarded Filtration Procedure for Primary Open Angle Glaucoma

A Review of the Ahmed Glaucoma Valve Implant and Comparison with Other Surgical Operations

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Comparison of trabeculectomy versus Ex-PRESS: 3-year follow-up

Abstract: NCT01263561; post results.

Cited by 50 publications

References 13 publications

Factors influencing the filtration-bleb volume after Ex-PRESS<sup>&reg;</sup> surgery

Factors influencing the filtration-bleb volume after Ex-PRESS<sup>&reg;</sup> surgery

Stab Incision Glaucoma Surgery: A Modified Guarded Filtration Procedure for Primary Open Angle Glaucoma

A Review of the Ahmed Glaucoma Valve Implant and Comparison with Other Surgical Operations

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Product

Resources

About

Factors influencing the filtration-bleb volume after Ex-PRESS<sup>®</sup> surgery

Factors influencing the filtration-bleb volume after Ex-PRESS<sup>®</sup> surgery