Document Detail


Ex-PRESS R-50 miniature glaucoma implant insertion under the conjunctiva combined with cataract extraction.
MedLine Citation:
PMID:  17964403     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To evaluate the efficacy and safety of the Ex-PRESS R-50 implant (Optonol Ltd.) in eyes operated on for open-angle glaucoma combined with phacoemulsification. SETTING: Glaucoma Unit, Ophthalmology Department, University of Lausanne, Lausanne, Switzerland. METHODS: Between November 2000 and June 2002, the Ex-PRESS R-50 shunt was implanted in 35 eyes of 35 patients. The best corrected visual acuity (BCVA), intraocular pressure (IOP), number of medications, and complications were recorded preoperatively as well as postoperatively at 1 and 7 days and 1, 2, 3, 6, 9, 12, 24, 36, and 48 months. Temporal clear corneal phacoemulsification with intraocular lens implantation was performed first. The ophthalmic viscosurgical device was not removed, and the Ex-PRESS R-50 was implanted under the conjunctiva into the anterior chamber. RESULTS: The mean follow-up was 36.9 months +/- 18.2 (SD) and the mean age of the patients, 74.6 +/- 10.9 years. The mean preoperative IOP of 19.3 +/- 6.3 mm Hg decreased postoperatively to 15.3 +/- 6.2 mm Hg, 15.1 +/- 4.6 mm Hg, 13.8 +/- 2.8 mm Hg, 14.6 +/- 2.9 mm Hg, and 13.3 +/- 2.0 mm Hg at 6 months, 12 months, 24 months, 36 months, and 48 months, respectively (P<.005). At 48 months, the mean BCVA was 0.74 +/- 0.34 and the number of medications was reduced by 57% (P<.005). The microtube was removed in 10 patients, and bleb management was performed in 10 eyes. Ten patients (32%) had satisfactory IOP control (mean 13.2 +/- 2.2 mm Hg) without medication; minor transient complications were observed in 10 patients. Based on the cumulative survival curve after 48 months, the complete success rate was 32.7% and the qualified success rate, 53.7% (P<.05). CONCLUSIONS: Ex-PRESS R-50 implantation under the conjunctiva was associated with a relatively high number of complications, despite good IOP control in the uncomplicated cases. Refinement in the tube design and implantation technique would increase the success rate.
Authors:
Delphine Rivier; Sylvain Roy; André Mermoud
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of cataract and refractive surgery     Volume:  33     ISSN:  0886-3350     ISO Abbreviation:  J Cataract Refract Surg     Publication Date:  2007 Nov 
Date Detail:
Created Date:  2007-10-29     Completed Date:  2007-12-20     Revised Date:  2008-06-16    
Medline Journal Info:
Nlm Unique ID:  8604171     Medline TA:  J Cataract Refract Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1946-52     Citation Subset:  IM    
Affiliation:
Glaucoma Unit, Jules Gonin Eye Hospital, University of Lausanne, Lausanne, Switzerland.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Anterior Chamber / surgery*
Conjunctiva / surgery*
Female
Follow-Up Studies
Glaucoma Drainage Implants*
Glaucoma, Open-Angle / surgery*
Humans
Intraocular Pressure / physiology
Lens Implantation, Intraocular
Male
Middle Aged
Phacoemulsification*
Prospective Studies
Prosthesis Implantation / methods*
Tonometry, Ocular
Treatment Outcome
Visual Acuity / physiology
Comments/Corrections
Comment In:
J Cataract Refract Surg. 2008 May;34(5):716; author reply 716-7   [PMID:  18471612 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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