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Results of ExPRESS implantation alone or combined with phacoemulsification in OAG patients

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Session Details

Session Title: Presented Poster Session: Glaucoma

Venue: Poster Village: Pod 2

First Author: : E.Tunca Kirikkaya TURKEY

Co Author(s): :    A. Asici   M. Yilmazli   A. Ustuner        

Abstract Details

Purpose:

To compare the efficacy, safety and see the results and complications of Ex-press device implantation alone (Ex-Press) or with phacoemulsification (P-Ex-Press) in patients with open angle glaucoma (OAG) and possible cataract existence. Patients had glaucoma that could not be controlled with maximal-tolerated anti glaucoma medications and some of them had drug allergy. Ex-Pres device was introduced as an alternative to trabeculectomy (which is the gold standard procedure used in the treatment of glaucoma).

Setting:

Patients from the Glaucoma Department of the ─░stanbul Eye Hospital at ─░stanbul, Turkey were included for this study.

Methods:

Subjects diagnosed of OAG underwent Ex-Press implantation alone or combined with phacoemulsification. 41 eyes were included. 20 eyes were treated with P-Ex-Press and 21 eyes with Ex-Press alone. There were no statistical differences in the number of cases between the groups (p>0.05).Mean age was 70. 19 female and 22 male patients were involved. There were no statistical differences in the age and gender between the groups(p>0.05). Cases were followed postoperatively for 12 months. The main outcome measures were: Mean intra ocular pressure(IOP), IOP reduction levels,the reduction in glaucoma medications,the change of visual acuity,incidence of postoperative complications.

Results:

Aftter12months:AverageIOP lowering in the P-Ex-Press group was from 34,6-to-15,3 mmHg and in the Ex-Press group was from 31,2-to-14,1(p>0.05).Medications went from 2,5-to-0.5 in the P-Ex-Press group whereas in the Ex-Press group went from 2,8-to-0.6(p>0.05). The visual acuity went from 0.25-to-0.54 in the P-ExPress group and didn't change in the Ex-Press group.Early hypotony was common.The most frequent complication was shallow anterior chamber (2-and -1 in P-Express versus Ex-Press group). In the P-Ex-PRESS there was an one case of bleb needling and one of bleb revision. In the Ex-Press group 1 eye required bleb revision and 1-required re-suturing.

Conclusions:

Both treatment groups demonstrated significant IOP decreases from baseline. Both groups had significant decreases versus baseline in the mean number of IOP-lowering medications. 60% of the patients needed no further medical treatment in both of groups. Visual acuity was evidently improved in the majority of patients in P-Ex-Press group due to Phacoemusification. Visual acuity in the Express group was similar pre and post operatively. Both goups had a low rate of postoperative complication. This were shallow anterior chamber, hypotony, hyphema. The P-Ex-Press group had a lower rate of postoperative interventions required then Ex-Press group.

Financial Disclosure:

NONE

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