Comparison of Ex-PRESS P-200 mini-shunt implantation and standard trabeculectomy for open-angle glaucoma: four-year follow-up

Introduction The study aimed to evaluate the efficacy and safety in 4-year follow-up of Ex-PRESS P-200 mini-shunt implantation versus standard trabeculectomy. Material and methods A single-center retrospective study on patients diagnosed with open-angle glaucoma with failed medical treatment and wh...

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Bibliographic Details
Main Authors: Cristina Nicula, Dorin Nicula, Anca Rednik, Adriana Elena Bulboacă, Sorana D. Bolboacă
Format: Article
Language:English
Published: Termedia Publishing House 2019-11-01
Series:Archives of Medical Science
Subjects:
Online Access:https://www.archivesofmedicalscience.com/Comparison-of-Ex-PRESS-P-200-mini-shunt-implantation-and-standard-trabeculectomy,113238,0,2.html
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Summary:Introduction The study aimed to evaluate the efficacy and safety in 4-year follow-up of Ex-PRESS P-200 mini-shunt implantation versus standard trabeculectomy. Material and methods A single-center retrospective study on patients diagnosed with open-angle glaucoma with failed medical treatment and who underwent Ex-PRESS device implantation or standard trabeculectomy was conducted. Seventy-three eyes were included in the analysis, 33 with Ex-PRESS P-200 implantation and 40 with standard trabeculectomy. Results Significant decreases in the intraocular pressure (IOP) were observed after surgery and at all follow-ups in both groups (p 0.40). No significant differences with regard to post-operative medications were observed (p > 0.10). Excepting the 3-year follow-up, when just a borderline significant difference regarding the visual acuity between the Ex-PRESS and standard trabeculectomy group was observed (p = 0.0504), the Ex-PRESS groups showed significantly better visual acuity at 6 weeks (p = 0.0324), 1 year (p = 0.0168), 2 years (p = 0.0162), and 4 years (p = 0.0111). Hypotony occurred more frequently among the Ex-PRESS group, while cataract occurred more frequently among those with standard trabeculectomy, without significant differences between groups (p > 0.09). No difference in hazard of failure was observed between interventions (HR = 0.72, p = 0.523). Conclusions Both procedures provided good control of IOP and decreased the number of postoperative medications. The advantage of the Ex-PRESS shunt is the better visual acuity, but its main limitation is the cost.
ISSN:1734-1922
1896-9151