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The Ex-PRESS glaucoma shunt versus trabeculectomy in open-angle glaucoma: a prospective randomized study
1Ophthalmology Department, Academic Medical Centre, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands. leo.dejong@tiscali.nl
Advances in Therapy
|April 2, 2009
Summary
The Ex-PRESS mini glaucoma shunt demonstrated superior efficacy compared to trabeculectomy in treating open-angle glaucoma. This safe and effective device offers higher success rates with comparable complication rates.
Area of Science:
- Ophthalmology
- Glaucoma Surgery
- Medical Devices
Background:
- Open-angle glaucoma is a leading cause of irreversible blindness.
- Current surgical treatments aim to reduce intraocular pressure (IOP).
- The Ex-PRESS mini glaucoma shunt is a novel device for glaucoma management.
Purpose of the Study:
- To evaluate the efficacy and safety of the Ex-PRESS mini glaucoma shunt.
- To compare Ex-PRESS implantation with trabeculectomy in open-angle glaucoma patients.
Main Methods:
- Prospective, randomized trial comparing Ex-PRESS implantation and trabeculectomy.
- Primary outcome measures included intraocular pressure (IOP), medication use, visual acuity, and complications.
- Complete success defined as IOP between 4-18 mmHg without medication.
Main Results:
- Ex-PRESS achieved significantly higher complete success rates (84.6%) versus trabeculectomy (60.0%) (P=0.0230).
- Higher success rates were observed for a stringent IOP target (4-15 mmHg) with Ex-PRESS (76.9%) vs. trabeculectomy (50.0%) (P=0.0193).
- At 1-year follow-up, Ex-PRESS maintained superior success rates with similar complication rates.
Conclusions:
- The Ex-PRESS mini glaucoma shunt is a safe and effective alternative for open-angle glaucoma.
- Ex-PRESS implantation yields significantly higher success rates than trabeculectomy.
- The device offers comparable safety profiles to traditional glaucoma surgery.
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