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First Author: S.Srivastava INDIA
Co Author(s): M. Khamar V. Vasavada D. Agrawal A. Vasavada V. Vasavada
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To evaluate outcomes of Ex-PRESS Glaucoma drainage device (GDD) placed under partial-thickness scleral flap over a 1 year follow-up period
Iladevi Cataract & IOL Research Centre
22 eyes (20 patients) undergoing Glaucoma Drainage Device (Ex-PRESS, Alcon Laboratories) implantation for medically uncontrolled primary open angle glaucoma, completing 1 year postoperative follow-up were included. Single surgeon performed all surgeries using a standardized technique. Outcome measures included Intraocular Pressure (IOP), postoperative complications and medication use. Postoperative data to be collected at 1 week, 1, 3, 6, and 12 months. Unqualified Success defined as an IOP of > 4 mmHg and ?18 mmHg without the use of antiglaucoma medications, Qualified Success defined as the same as unqualified success, but with use of IOP-lowering medications and Treatment failure defined as the need for additional IOP lowering surgery.
Average follow-up was 26+1.23 months. Mean preoperative IOP was 20.36+5.08 mmHg, which dropped significantly to 15.41+4.7 at 1 month, 13.34+3.5 at 3 months, 13.03+3.5 at 6 months and 12.85+4.1 at 1 year. Unqualified success was achieved in 20 eyes (90.4%) at 6 months and 17 eyes (77%) at 1 year. Of the 3 eyes that needed glaucoma medications, two were controlled with 1 medication whereas 1 eye needed 2 medications. Mean number of medications reduced from preoperatively 2.47 (range 1 to 4) to at 1 year postoperatively. 2 eyes (9%) had early postoperative shallowing of the anterior chamber, but they settled with conservative management. 2 eyes with pre-existing cataract required cataract surgery within 3 months of the glaucoma surgery.
ExPRESS Glaucoma drainage device provides good postoperative IOP control with minimal postoperative complications.