EX-PRESS Ab Externo Revision With a 41-G Needle

Area of Science:

• Ophthalmology
• Glaucoma Surgery
• Surgical Devices

Background:

• The EX-PRESS Glaucoma Filtration Device is a nonvalved implant used to manage intraocular pressure by facilitating aqueous humor drainage.
• Postoperative elevated intraocular pressure after implantation can signal device occlusion or fibrosis, jeopardizing filtration success.

Observation:

• Conventional bleb revision techniques were ineffective in restoring flow in a case of suspected EX-PRESS device occlusion.
• An extendible 41-G subretinal injection needle was utilized as an alternative approach.

Findings:

• The novel needle technique successfully reestablished patency of the EX-PRESS Glaucoma Filtration Device.
• Timely restoration of aqueous humor flow was achieved, preventing bleb failure.

Implications:

• This technique offers a potential solution for managing occluded glaucoma drainage devices when standard revisions fail.
• It may improve outcomes for patients with glaucoma requiring filtration surgery.