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Objective:
To evaluate the short-term clinical efficacyand safety of ExPRESS glaucomafiltrationdevice irnplantation for the treatment of refiactory glaucoma.
Methods:
This wasaretrospective study of29eyes of28cases with refiactory glaucomaimplantedExPRESS glaucomafiltration device.The preoperativeand postoperative best correctedvisualacuity(BCVA),preoperative intraocular pressure(IOP)at lweek,1month,and3monthsafter surgery,and postoperative complications were observed.According to theloose criterion(≤21mmHg),medium criterion(≤16mmHg),strict criterion(≤12mmHg),and personal target IOP,theacceptability rate ofpostoperative IOPat l week,1month,and3months was evaluated by Chi-square test.The comparison ofthe IOPamong before thesurgery,1week,1month,and3monthsafter surgery wereanalyzed byanalysis of variance(ANOVA)and least significant difference(LSD).The postoperative IOPat3months fiom8eyes with refractory glaucoma,which received the implantation ofAhmed glaucomavalve,was compared with the IOPat3months from18eyes that continue to follow up by ttest.
Result:
Twenty-nine eyes of28patients with refiactory glaucomawere included,ofwhich15eyeswere presented with recurrent glaucoma,6eyes with neovascular glaucoma,5eyes withaphakia,3eyesafier uveitis,3eyesafier vitrectomy,and2eyes with lens dislocationafiertrauma.Afier3months of follow-up,BCVAof13eyes improved,11eyes unchangedand3eyes decreased,except for2eyes with no light perception preoperatively.The IOP ofeyes before surgery were31.72±8.76mmHg,and9.5±2.62mmHg,13.17±9.27mmHg,14±5.38mmHgat1week,1month,and3monthsafier surgery,respectively.As forreaching the standard,96.55％of eyes were controlled under strict criterion,100％undermediumand loose criterionat1weekafier surgery.However,at1monthafier surgery,80.77％,84.62％and96.15％of eyes were controlled under strict,mediumand loosecriterion,respectively.Furthermore,the respective proportions were50.0％,77.78％and94.44％at3monthsafter surgery.Meanwhile,100％ofeyes reached personal target IOPlevelat lweekafier surgery,and76.92％at1month,44.44％at3months.The differencewas found to be significant(P=O.OOO)when we compared the IOP before surgery withIOPafier surgery in lweek,1monthand3months.The comparison of the IOPamong beforethe surgery,1week,1month,and3monthsafter surgery done using LSD showed thatthere were no significant difference between1weekand1month(P=0.123),between1weekand3months(P=0.059),and between l monthand3months(P=0.724).As for thecomplications,3eyesappeared filtering bleb leakage,5eyes with shallowanterior chamberor choroidal detachment,1eye with ExPRESS obstruction,and1eye with filtering blebscarring.The mean IOP of8eyes with the implantation ofAhmed glaucomavalve was13.0±3.93mmHg,there was no significant difference compared the IOP with theimplantation ofExPRESS glaucomafiltration device(P=0.588).
Conclusion:
The use of the ExPRESS glaucomafiltration device for the treatment of refractoryglaucomawas safeand effective for maintaining the BCVA,controlling IOP,anddecreasing the complicationat the early stageafier surgery.In this period,the implantationof ExPRESS canacquire the sameavailability for controlling ofIOPas the use theAhmedglaucomavalve.
To evaluate the short-term clinical efficacyand safety of ExPRESS glaucomafiltrationdevice irnplantation for the treatment of refiactory glaucoma.
Methods:
This wasaretrospective study of29eyes of28cases with refiactory glaucomaimplantedExPRESS glaucomafiltration device.The preoperativeand postoperative best correctedvisualacuity(BCVA),preoperative intraocular pressure(IOP)at lweek,1month,and3monthsafter surgery,and postoperative complications were observed.According to theloose criterion(≤21mmHg),medium criterion(≤16mmHg),strict criterion(≤12mmHg),and personal target IOP,theacceptability rate ofpostoperative IOPat l week,1month,and3months was evaluated by Chi-square test.The comparison ofthe IOPamong before thesurgery,1week,1month,and3monthsafter surgery wereanalyzed byanalysis of variance(ANOVA)and least significant difference(LSD).The postoperative IOPat3months fiom8eyes with refractory glaucoma,which received the implantation ofAhmed glaucomavalve,was compared with the IOPat3months from18eyes that continue to follow up by ttest.
Result:
Twenty-nine eyes of28patients with refiactory glaucomawere included,ofwhich15eyeswere presented with recurrent glaucoma,6eyes with neovascular glaucoma,5eyes withaphakia,3eyesafier uveitis,3eyesafier vitrectomy,and2eyes with lens dislocationafiertrauma.Afier3months of follow-up,BCVAof13eyes improved,11eyes unchangedand3eyes decreased,except for2eyes with no light perception preoperatively.The IOP ofeyes before surgery were31.72±8.76mmHg,and9.5±2.62mmHg,13.17±9.27mmHg,14±5.38mmHgat1week,1month,and3monthsafier surgery,respectively.As forreaching the standard,96.55％of eyes were controlled under strict criterion,100％undermediumand loose criterionat1weekafier surgery.However,at1monthafier surgery,80.77％,84.62％and96.15％of eyes were controlled under strict,mediumand loosecriterion,respectively.Furthermore,the respective proportions were50.0％,77.78％and94.44％at3monthsafter surgery.Meanwhile,100％ofeyes reached personal target IOPlevelat lweekafier surgery,and76.92％at1month,44.44％at3months.The differencewas found to be significant(P=O.OOO)when we compared the IOP before surgery withIOPafier surgery in lweek,1monthand3months.The comparison of the IOPamong beforethe surgery,1week,1month,and3monthsafter surgery done using LSD showed thatthere were no significant difference between1weekand1month(P=0.123),between1weekand3months(P=0.059),and between l monthand3months(P=0.724).As for thecomplications,3eyesappeared filtering bleb leakage,5eyes with shallowanterior chamberor choroidal detachment,1eye with ExPRESS obstruction,and1eye with filtering blebscarring.The mean IOP of8eyes with the implantation ofAhmed glaucomavalve was13.0±3.93mmHg,there was no significant difference compared the IOP with theimplantation ofExPRESS glaucomafiltration device(P=0.588).
Conclusion:
The use of the ExPRESS glaucomafiltration device for the treatment of refractoryglaucomawas safeand effective for maintaining the BCVA,controlling IOP,anddecreasing the complicationat the early stageafier surgery.In this period,the implantationof ExPRESS canacquire the sameavailability for controlling ofIOPas the use theAhmedglaucomavalve.