Interference of Descemet's Membrane with Aqueous Humor Drainage via an ExPRESS Mini Shunt

Tamaki, Rikiya; Zako, Masaru

doi:10.1159/000368697

Cited by 3 publications

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References 3 publications

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“…Perforation of Descemet’s membrane has also been reported. 18 The direction of Ex-PRESS insertion and number of sutures in the scleral flap require further investigation.…”

Section: Discussionmentioning

confidence: 99%

Indications and postoperative treatment for Ex-PRESS® insertion in Japanese patients with glaucoma: comparison with standard trabeculectomy

Kato¹,

Takahashi²,

Kumegawa³

et al. 2015

OPTH

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BackgroundWe investigated indications and early postoperative treatment for Ex-PRESS® insertion for glaucoma by comparing postoperative outcomes with those for standard trabeculectomy.MethodsEx-PRESS insertion was performed in 21 eyes and standard trabeculectomy (TLE) in 22 eyes. Mean intraocular pressure (IOP) in the 6 months after surgery, success rate for postoperative IOP decline, postoperative complications, postoperative treatment, filtering blebs, and indications were then retrospectively investigated.ResultsMean postoperative IOP did not differ significantly between the groups at any observation time for 6 months after surgery. Further, it did not differ between either the groups of patients with primary open-angle glaucoma (POAG) and neovascular glaucoma (NTG), or the patients with primary open-angle glaucoma and NTG in the Ex-PRESS group. Comparison of success rates in reduction of postoperative IOP between the groups under the following four survival conditions showed no significant differences: postoperative IOP <30% of the preoperative IOP, complete success (no additional ophthalmic solution), and qualified success (ophthalmic solution required); 5 mmHg ≤ postoperative IOP ≤21 mmHg, complete success (no additional ophthalmic solution), and qualified success (ophthalmic solution required). With regard to postoperative complications and postoperative treatment, the incidence of hyphema was significantly lower in the Ex-PRESS group, but no other significant intergroup differences were seen. The height of the filtering bleb was lower in the Ex-PRESS group.ConclusionPostoperative outcomes in the Ex-PRESS and TLE groups were comparable. The incidence of hyphema was significantly lower in the Ex-PRESS group. Ex-PRESS insertion appears to be useful in patients with NTG and in those prone to postoperative bleeding. There were no significant intergroup differences in postoperative treatment. Assessment of outcome after Ex-PRESS insertion was difficult in some patients. Postoperative treatment should be developed to suit the specific requirements of Ex-PRESS insertion.

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“…Perforation of Descemet’s membrane has also been reported. 18 The direction of Ex-PRESS insertion and number of sutures in the scleral flap require further investigation.…”

Section: Discussionmentioning

confidence: 99%

Indications and postoperative treatment for Ex-PRESS® insertion in Japanese patients with glaucoma: comparison with standard trabeculectomy

Kato¹,

Takahashi²,

Kumegawa³

et al. 2015

OPTH

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Surgical outcomes of patients with iridocorneal endothelial syndrome: a case series

et al. 2016

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The purpose of this study is to report the intermediate-term surgical outcomes of patients with iridocorneal endothelial syndrome-related glaucoma. The medical records of four patients (five eyes) surgery (Ahmed glaucoma valve implantation surgery and EX-PRESS mini shunt) were retrospectively reviewed. Median follow-up after glaucoma surgery was 24 (15-36) months. The preoperative intraocular pressure was significantly reduced from a median of 33 (22.5-36) mmHg on a median of 4 (4-5) glaucoma medications to a median of 12 (10.5-14.5) mmHg on a median of 2 (0-2) medications at last follow-up after surgery (p = 0.043 for IOP and p = 0.042 for glaucoma medications). Median preoperative visual acuity [0.016 (0.008-0.1)] did not change significantly when compared to median visual acuity at last follow-up [0.016 (0.004-0.5)] (p = 0.59). Intraocular pressure control in patients with iridocorneal endothelial syndrome is challenging and may require multiple operations and revisions. Some modifications during glaucoma drainage implant surgery and use of EX-PRESS mini shunt in certain cases could offer an advantage in these patients.

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Interference of Descemet's Membrane with Aqueous Humor Drainage via an ExPRESS Mini Shunt

Cited by 3 publications

References 3 publications

Indications and postoperative treatment for Ex-PRESS® insertion in Japanese patients with glaucoma: comparison with standard trabeculectomy

Indications and postoperative treatment for Ex-PRESS® insertion in Japanese patients with glaucoma: comparison with standard trabeculectomy

Surgical outcomes of patients with iridocorneal endothelial syndrome: a case series

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Interference of Descemet's Membrane with Aqueous Humor Drainage via an ExPRESS Mini Shunt

Cited by 3 publications

References 3 publications

Indications and postoperative treatment for Ex-PRESS&reg; insertion in Japanese patients&nbsp;with glaucoma: comparison with standard trabeculectomy

Indications and postoperative treatment for Ex-PRESS&reg; insertion in Japanese patients&nbsp;with glaucoma: comparison with standard trabeculectomy

Surgical outcomes of patients with iridocorneal endothelial syndrome: a case series

Betamethasone

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Indications and postoperative treatment for Ex-PRESS® insertion in Japanese patients with glaucoma: comparison with standard trabeculectomy

Indications and postoperative treatment for Ex-PRESS® insertion in Japanese patients with glaucoma: comparison with standard trabeculectomy