Preliminary reports on efficiency of use Ex-PRESS glaucoma filtration device in advanced glaucoma
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Abstract
Purpose: The evaluation of effectiveness of Ex-PRESS glaucoma filtration device in both primary and secondary advanced glaucoma.
Material and methods: The study group of 38 patients with advanced glaucoma underwent implantation of glaucoma filtrating device Ex-PRESS type P-50. Shunts were placed underneath a scleral flap, without the use of antimetabolites. During the 4-month follow-up the main measures of the outcome were IOP and VA. In those with absolute or almost absolute glaucoma we evaluated local symptoms and relief of pain.
Results: Patients from the study group obtained significant reduction of IOP in early postoperative period (one week). During 4-month we observed that IOPs of those with an inflammatory glaucoma or neovascular glaucoma returned to the levels from before the implantation. Patients with primary glaucoma or post- -traumatic glaucoma maintained the lower IOP in 4-month observation. VA of most of the patients improved. Six of eight patients with absolute glaucoma who suffered from pain caused by the high IOP confirmed total relief.
Conclusions: Ex-PRESS P-50 implantation seems to be effective method of reducing IOP in patients with advanced glaucoma. In short-term follow-up we achieved reduce IOP, improve VA and reduce the pain in patients qualified for enucleation. However, in longer follow-up the IOP rise and more intensive local pharmacological hypotensive treatment is demanded. Better results are presented in those with primary glaucoma and post-traumatic glaucoma. Higher risk of complications during and after the surgery altogether with worse results were observed in patients with neovascular glaucoma and inflammatory glaucoma. Further long-term studies are necessary to fully assess safety and evaluate the effectiveness described procedure.
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Address reprint requests to: Medical Education, Marcin Kuźma (marcin.kuzma@mededu.pl)
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