EX-PRESS Glaucoma Filtration Device: efficacy, safety, and predictability

Chan, Jessica; Netland, Peter A.

doi:10.2147/mder.s63350

Cited by 16 publications

(12 citation statements)

References 28 publications

(62 reference statements)

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“…A 25-G needle was then passed into the AC from under the flap and the EX-PRESS (P-50 model) was placed into the sclerostomy as described previously. 16 After reapproximation of the scleral flap with 10-0 nylon sutures, the conjunctiva was closed in a water tight fashion using 8-0 vicryl suture. Two wing sutures were used for all closures.…”

Section: Methodsmentioning

confidence: 99%

“…A fornix-based conjunctival flap was created superiorly, and a partial-thickness scleral flap was constructed at the limbus. A 25-G needle was then passed into the AC from under the flap and the EX-PRESS (P-50 model) was placed into the sclerostomy as described previously 16. After reapproximation of the scleral flap with 10-0 nylon sutures, the conjunctiva was closed in a water tight fashion using 8-0 vicryl suture.…”

Section: Methodsmentioning

confidence: 99%

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A Comparison of Clinical Outcomes After XEN Gel Stent and EX-PRESS Glaucoma Drainage Device Implantation

Stoner

Young

SooHoo

et al. 2021

Journal of Glaucoma

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Precis: Although the XEN stent offers a lower risk of hypotony and choroidal effusions with fewer clinic visits postoperatively, its surgical success rate was inferior to the EX-PRESS shunt.Purpose: To compare the clinical efficacy and safety outcomes of the XEN stent and EX-PRESS glaucoma drainage device in glaucomatous eyes.Materials and Methods: One hundred eyes from 88 patients underwent ab interno XEN stent or EX-PRESS shunt implantation (52 XEN and 48 EX-PRESS) for uncontrolled glaucoma at the University of Colorado Eye Center. The primary outcome was surgical success defined as intraocular pressure (IOP) ≥ 6 and ≤ 18 mm Hg, without reoperation for uncontrolled glaucoma, loss of light perception, or use of glaucoma medications (complete success). Secondary outcomes were the same requirements allowing for medications (qualified success), mean IOP, medication use, adverse events, and number of postoperative clinic visits in the first 3 months.Results: Baseline characteristics including glaucoma type and severity were similar between groups, with the exception of XEN patients having fewer men (17% vs. 46%), older patients (median age, 78 vs. 68), and a higher percentage of white patients (89% vs. 69%). Adjusted hazard ratio of failure of XEN relative to EX-PRESS was 3.94 (95% confidence interval, 1.73-9.00, P = 0.001) for complete success and 1.61 (95% confidence interval, 0.40-6.38, P = 0.501) for qualified success. There were significantly fewer postoperative clinic visits during the first 3 months in the XEN group (5.3 vs. 9.1 visits, P < 0.001). The incidence of serous choroidal effusions and hypotony was significantly less after XEN compared with EX-PRESS (1 vs. 9, P = 0.02 and 15 vs. 25, P = 0.023, respectively). Three XEN stents (5.8%) required removal. Conclusions:In this population, although the XEN stent offers a better safety profile and fewer postoperative clinic visits, complete surgical success was inferior to the EX-PRESS shunt.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

A Comparison of Clinical Outcomes After XEN Gel Stent and EX-PRESS Glaucoma Drainage Device Implantation

Stoner

Young

SooHoo

et al. 2021

Journal of Glaucoma

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“…Trabeculectomy (TBC) was introduced by Cairns in 1968 as a surgical procedure for glaucoma, and it is the procedure of choice for surgical open-angle glaucoma treatment. 3 …”

Section: Introductionmentioning

confidence: 99%

“… 4 , 5 These complications have motivated the development of alternative techniques and devices, including the EX-PRESS ® glaucoma filtration device. 3 , 6 …”

Section: Introductionmentioning

confidence: 99%

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

Mendoza-Mendieta¹,

Lopez-Venegas²,

Valdés-Casas³

2016

OPTH

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PurposeTo evaluate the EX-PRESS P-50 implant compared to standard trabeculectomy (TBC).MethodsSingle-center prospective randomized study; 20 eyes of 20 patients were treated with the EX-PRESS P-50 implant, and 20 eyes of 20 patients with TBC, over a 19-month period. Records of all patients were reviewed and compared. Success was defined as intraocular pressure (IOP) <21 and >5 mmHg or a decrease of 30% of IOP. Failure was defined as >21 mmHg or decline in visual acuity. Statistical analysis was made with Student’s t-test and χ2 test analyzed with SPSS version 13.0.ResultsThe average follow-up was 8.6 months (±4.9 months) for the EX-PRESS P-50 group and 9.6 months (±5.3 months) for the TBC group. The postoperative visual acuity and IOP were not significantly different. We report more complications in the EX-PRESS P-50 group. At 3, 6, and 12 months follow-up, the control group was found to be free of complications, whereas multiple complications were observed in the EX-PRESS P-50 group at 3 and 6 months follow-up. We found no differences in either group with respect to success.ConclusionBoth procedures are equally effective for the treatment of glaucoma, with 80% success in the EX-PRESS P-50 group and 72.7% in the control group.

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“…However, complications such as erosion, displacement, and blockage of the implant, as well as hypotony are commonly reported. 231…”

Section: Microfluidics Of Minimally Invasive Glaucoma Surgery (Migs) ...mentioning

confidence: 99%

Microfluidics in the eye: a review of glaucoma implants from an engineering perspective

Fang,

Bi,

Brown

et al. 2023

Lab Chip

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EX-PRESS Glaucoma Filtration Device: efficacy, safety, and predictability

Cited by 16 publications

References 28 publications

A Comparison of Clinical Outcomes After XEN Gel Stent and EX-PRESS Glaucoma Drainage Device Implantation

A Comparison of Clinical Outcomes After XEN Gel Stent and EX-PRESS Glaucoma Drainage Device Implantation

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

Microfluidics in the eye: a review of glaucoma implants from an engineering perspective

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