Document Detail


Assessment of Bleb Morphologic Features and Postoperative Outcomes after Ex-PRESS Drainage Device Implantation versus Trabeculectomy.
MedLine Citation:
PMID:  21236403     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
PURPOSE:: To investigate bleb morphologic features and postoperative outcomes after Ex-PRESS drainage device (Alcon Laboratories) implantation versus trabeculectomy. DESIGN:: Retrospective, consecutive case-control series. METHODS:: Information was collected from the charts of 35 consecutive Ex-PRESS procedures and 35 consecutive trabeculectomy procedures with at least 2 years of follow-up. Intraocular pressure (IOP), bleb morphologic features, reduction of dependence on medication, visual recovery, number of postoperative visits, and postoperative complication rates were compared between groups. RESULTS:: Average follow-up was 28 months (standard deviation, 3.23 months). Mean IOP measurements were similar after 6 months, then became slightly higher in the Ex-PRESS group at 1 year and at the final follow-up (P = .004 and P = .008, respectively). Final percent IOP lowering was similar between groups (P = .209). Unqualified success was achieved in 77.14% of Ex-PRESS and 74.29% of trabeculectomy procedures at last follow-up (P = 1.00). An additional 5.71% and 8.57% reached qualified success for Ex-PRESS and trabeculectomy surgeries, respectively (P = .99). Evaluation by the Moorfields Bleb Grading System revealed less vascularity and height but more diffuse area associated with the Ex-PRESS blebs, although these differences were absent at study completion. There were fewer cases of early postoperative hypotony and hyphema and quicker visual recovery in the Ex-PRESS group. The Ex-PRESS group required fewer postoperative visits compared with the trabeculectomy group (P < .000). CONCLUSIONS:: Success of Ex-PRESS surgery, as defined in our study, was similar to trabeculectomy. Final IOP measurements were slightly lower after trabeculectomy compared with Ex-PRESS. Differences in some postoperative outcomes faded with follow-up. There remains a need for long-term prospective studies comparing these 2 procedures.
Authors:
Travis J Good; Malik Y Kahook
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-1-12
Journal Detail:
Title:  American journal of ophthalmology     Volume:  -     ISSN:  1879-1891     ISO Abbreviation:  -     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2011-1-17     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370500     Medline TA:  Am J Ophthalmol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 Elsevier Inc. All rights reserved.
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