Evaluation of Ex-Press Glaucoma Filtration Device in Primary Open Angle Glaucoma

Purpose: The aim of this study was to compare the outcomeof Ex_PRESS mini shunt versus standard trabeculectomy in cases of primary open angle glaucoma.

Setting: Mansoura Ophthalmic Center, Mansoura University, Mansoura, Egypt.

Design: comparative prospective non randomaized study.

Methods: study included 36 eyes of 25 patients with uncontrolled primary open angle glaucoma. 17 eyes had trabeculectomy and 19 eyes had Ex-PRESS glaucoma mini shunt. Demographic data, preoperative complete ophthalmic examination, surgical procedure used are all recorded. Postoperative examination included intraocular pressure (IOP), visual acuity and number of glaucoma medications. Surgical success and complications were recorded.

Results: We reported no significant difference between Ex-PRESS and trabeculectomy groups regarding IOP reduction, success rates and use of postoperative glaucoma medication except that IOP in the early post-operative period was lower in the trabeculectomy group. At 12 months IOP Complete success was achieved in 76.5% and 84.2% in trabeculectomy and Ex_PRESS groups respectively. Early hypotony was slightly higher in trabeculectomy group (29.4%) than in Ex_PRESS group (10.5 %) but not statistically significant. Faster recovery of vision was achieved following Ex_PRES Simplantation as vision near baseline levels was achieved from 1 week to 1 month post-operatively.

Conclusion: Ex-PRESS mini shunt is a safe and effective device for treating cases of primary open-angleglaucoma. It is comparable to trabeculectomy as regard IOP, number of anti glaucoma medications and success rate with slightly lower early postoperativecomplications and faster recovery of visual acuity

Keywords: glaucoma, trabeculectomy, Ex-PRESS, intraocular pressure.