Abstract
PURPOSE: The aim of this study is to assess the efficacy and safety of ExPress mini shunt in glaucoma patients of Middle Eastern descent.
METHODS: This is a prospective cohort study. Uncontrolled glaucoma patients were subjected to ExPress mini-shunt implant. Pre- and post-operative glaucoma clinical indices were measured and compared. Both intra- and postoperative complications and surgical success rates were assessed. In addition to comparing a group of combined ExPress mini-shunt implant with cataract surgery versus ExPress mini-shunt implant alone.
RESULTS: A total of 35 eyes of 31 patients were involved. The most common type of glaucoma was primary open-angle glaucoma in 13 eyes (37.1%). Fourteen eyes (40.0%) were combined ExPress device with cataract surgery. The mean intraocular pressure (IOP) (+/- standard deviation) at the last visit dropped from 24.6 mmHg (+/- 8.3) to 13.9 mmHg (+/- 4.5). There was a significant reduction in the number of postoperative glaucoma medications from 3.0 +/- 0.5 to 1.3 (+/- 0.7). In cases combined with cataract extraction, the patients required fewer anti-glaucoma medications. Complete success was achieved in 22 eyes (63%) and qualified success was achieved in 9 eyes (26%), whereas 4 eyes (11%) were considered a failure. The two most common complications encountered were hypotony (28.6%) and hyphema (11.4%).
CONCLUSION: Among the studied population of patients, ExPress offers IOP reduction that is comparable to reported rates following standard trabeculectomy. Postoperative hyphema was encountered at a slightly higher rate.