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Microincision cataract surgery combined with Ex-press (P-50) implant under scleral flap and reticulate hyaluronic acid injection, for treatment of cataract and open angle...

Session Details

Session Title: Cataract I

Session Date/Time: Friday 03/02/2012 | 10:30-12:30

Paper Time: 10:42

Venue: Hall 1

First Author: : R.Altafini ITALY

Co Author(s): :    S. Morselli              

Abstract Details


To evaluate the efficacy and safety of the Ex-press (p-50) implant in reducing intra-ocular pressure, implanted under the scleral flap and reticulate hyaluronic acid with 2 mm micro incision phacoemulsification (MICS) and IOL implantation in patients with open angle glaucoma, after two years of follow up.


Ophthalmology Department “S.Bassiano Hospital”, Bassano del Grappa, Vicenza – Italy


Forty eight eyes of 41 patients with open angle glaucoma and cataract were considered for our study. All eyes underwent clear-cornea MICS phacoemulsification with Stellaris Machine and MI60 IOL implantation, Ex-press (P-50) implantation under scleral flap and combined injection of reticulate hyaluronic acid on the top of the scleral flap before closing the conjunctival wound. The injection of reticulate hyaluronic acid was used to maintain the bleb open for fifteen days. All patients were operated under topical anaesthesia. The mean follow up was two years after surgery. Each patient underwent ophthalmic examinations (IOP, visual field, gonioscopy, cup/disc ratio) before and after surgery. RESULTS The IOP decreased from 24,7 + 2,8 mmHg preoperatively to 10,5 + 2,1 mmHg at 6 months and 11,3 + 1.4 mmHg after the second post operative year. Postoperative complications were 3 cases of atalamia, 2 were solved with 1% viscoelastic injection, in one case a re-suture of the conjunctiva was necessary to solve the atalamia. We had one case of late post operative endophthalmitis, fifteen day after surgery, that was solved with vitrectomy and silicon oil injection. We had 5 cases of high IOP spike immediately after surgery that was solved with argon laser lysis of the nylon suture. Only 6 eyes needed one drug medication to maintain the IOP at the correct level.


After two year the Ex-press implant with combined reticulate hyaluronic acid on the top of the scleral flap was safe, simple and effective for reducing IOP and anti-glaucoma medication in open angle glaucoma eyes in combination with 2 mm MICS and IOL implantation.

Financial Disclosure:

... travel has been funded, fully or partially, by a company producing, developing or supplying the product or procedure presented