Trabeculectomy with Ex-PRESS implant versus Ahmed glaucoma valve implantation-a comparative study

• 作者: Elad Ben Artsi Gabi Shemesh Hadas Shalev Michael Waisbourd Naomi Fischer Oriel Spierer Rony Rachmiel Shimon Kurtz
• 来源期刊: 国际眼科杂志：英文版
• 学科: 医学
• 年，卷（期）: 2016,（10）
• 页码范围: 1415-1420
• 页数: 6页
• 分类号: R77

摘要

AIM:To compare the surgical outcomes of trabeculectomy with Ex-PRESS implant and Ahmed glaucoma valve(AGV) implantation. METHODS: Patients who underwent trabeculectomy with Ex-PRESS implants or AGV implantation separately were included in this retrospective chart review.Main outcome measures were surgical failure and complications.Failure was defined as intraocular pressure(IOP) >21 mm Hg or <5 mm Hg on two consecutive visits after 3mo,reoperation for glaucoma,or loss of light perception.Eyes that had not failed were considered as complete success if they did not required supplemental medical therapy.RESULTS: A total of 64 eyes from 57 patients were included: 31 eyes in the Ex-PRESS group and 33 eyes in the AGV group.The mean follow-up time was 2.6 ±1.1y and 3.3±1.6y,respectively.Patients in the AGV group had significantly higher baseline mean IOP(P =0.005),lower baseline mean visual acuity(VA)(P =0.02),and higher proportion of patients with history of previous trabeculectomy(P <0.0001).Crude failure rates were 16.1%,n =5/31 in the Ex-PRESS group and 24.2%,n =8/33 in the AGV group.The cumulative proportion of failure was similar between the groups,P =0.696.The proportion of eyes that experienced postoperative complications was32.3% in the Ex-PRESS group and 60.1% in the AGV group(P =0.0229).CONCLUSION: Trabeculectomy with Ex-PRESS implant and AGV implantation had comparable failure rates.The AGV group had more post-operative complications,but also included more complex cases with higher baselinemean IOP,worse baseline mean VA,and more previous glaucoma surgeries.Therefore,the results are limited to the cohort included in this study.