Long-term comparison using Ex-PRESS glaucoma shunt in black and white patients

To compare clinical outcomes, including patterns of failure, using the Ex-PRESS glaucoma shunt, in black and white patients with open-angle glaucoma.

Retrospective comparative study.

Sixty-three eyes of 50 black patients and 44 eyes of 34 white patients with open-angle glaucoma.

The Ex-PRESS shunt procedure was performed for uncontrolled glaucoma in a series of white and black patients with glaucoma. Success was defined as an intraocular pressure (IOP) between 5 and 18 mm Hg, 20% reduction from baseline, with or without suture lysis or adjuvant medication, but no additional glaucoma surgery.

Mean length of follow-up was 29 months (range 12-81 months) for black patients and 25 months (range 12-66 months) for white patients. Mean preoperative IOP was 27 ± 7.2 and 30 ± 7.7 mm Hg for black and white patients, respectively. Mean postoperative IOP was 13 ± 3.6 and 12 ± 3.3 mm Hg for black and white patients, respectively. Using Kaplan-Meier survival curves, the success rates were 77.6% and 95% at 12 months for black and white patients, respectively. The log-rank test for comparison of survival curves indicated a significant difference between the 2 groups at 12 months (p = 0 .015) but revealed no difference at 2 years (p = 0.462).

This study shows that patterns of failure between black and white patients treated with the Ex-PRESS glaucoma shunt change significantly with the passage of time. Black patients experience failure early, whereas white patients experience failure later at a greater pace resulting in a similar survival rate at 2 years.