Risk factors for Ex-Press^® surgery failure.

Area of Science:

• Ophthalmology
• Glaucoma Research
• Surgical Outcomes

Background:

• Glaucoma is a leading cause of irreversible blindness worldwide.
• The Ex-Press Glaucoma Filtration Device (EXP) is a surgical option to reduce intraocular pressure (IOP).
• Identifying risk factors for surgical failure is crucial for patient selection and management.

Purpose of the Study:

• To investigate potential risk factors associated with Ex-Press (EXP) surgery failure.
• To evaluate the long-term efficacy and safety of EXP surgery.

Main Methods:

• Retrospective, non-randomized study of 98 patients undergoing EXP surgery with ≥5 years follow-up.
• Investigated nine potential risk factors: age, gender, hypertension, diabetes mellitus, prior glaucoma surgery, glaucoma type, surgical approach, central corneal thickness, and preoperative IOP.
• Multivariate Cox regression models were used to determine risk factors for failure, defined as IOP reduction <20% or postoperative IOP >18 mmHg.

Main Results:

• EXP surgery significantly reduced IOP from 25.2±8.7 mmHg preoperatively to 11.1±4.1 mmHg at 5 years.
• The overall success rate of EXP surgery was 67.4% at the 5-year mark.
• No statistically significant risk factors were identified for EXP surgery failure (all p-values > 0.0587).

Conclusions:

• No preoperative factors reliably predict Ex-Press surgery failure.
• Ex-Press surgery demonstrates safety and efficacy in patients with primary open-angle glaucoma and pseudo-exfoliation glaucoma.