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Updated: Feb 24, 2026

Author Spotlight: Advancements in Refractive Surgical Correction for Presbyopia and Exploring Postoperative Visual Acuity
Published on: September 20, 2024
Visual acuity and corneal higher-order aberrations after EX-PRESS or trabeculectomy, and the determination of
Nobuko Kobayashi1, Kazuyuki Hirooka2, Eri Nitta1
1Department of Ophthalmology, Kagawa University Faculty of Medicine, 1750-1 Ikenobe, Miki, Kagawa, 761-0793, Japan.
Purpose:
This study investigated postoperative visual acuity and corneal higher-order aberrations following EX-PRESS or trabeculectomy.
Methods:
Out of 56 eyes of 56 patients analyzed, 30 eyes were treated using trabeculectomy, while 26 eyes were treated with EX-PRESS. Visual acuity and corneal higher-order aberrations were analyzed in both groups before and at 2 weeks, 1, 2, and 3 months after the surgeries. Risk factors that could potentially influence corneal higher-order aberrations were evaluated.
Results:
Significant reductions in the IOP were observed at 3 months after the surgery in both groups. Although a significant decrease in the visual acuity (logMAR) was observed at 2 weeks after the surgery in both groups, at 1 month after the surgeries, there were no significant differences found for the vision as compared to the baseline. At each study visit in the trabeculectomy group, significantly higher corneal higher-order aberrations compared to baseline were noted. In the EX-PRESS group, however, these aberrations were no longer significantly different from the baseline at month 2 (P = 0.36). Analysis of the risk factors indicated that hypotony could influence corneal higher-order aberrations after surgery.
Conclusions:
Corneal higher-order aberrations were significantly increased at 1 month after EX-PRESS treatment, with levels returning to baseline by 2 months. After trabeculectomy, however, corneal higher-order aberrations remained significantly increased at 3 months after the procedure.
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