EX-PRESS glaucoma filtration device: Review of clinical experience and comparison with trabeculectomy

Abstract Glaucoma filtration surgery is performed to reduce intraocular pressure (IOP) in patients for whom maximal tolerable pharmacologic IOP-lowering therapy and/or laser surgery fail to lower IOP sufficiently and/or fail to prevent optic nerve damage or visual field deterioration. For decades, t...

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Bibliographic Details
Published in:Survey of ophthalmology 2015-07, Vol.60 (4), p.327-345
Main Authors: Shaarawy, Tarek, MD, Goldberg, Ivan, MD, Fechtner, Robert, MD
Format: Article
Language:English
Subjects:
Aqueous Humor - physiology
glaucoma
Glaucoma - physiopathology
Glaucoma - surgery
Glaucoma Drainage Implants
glaucoma filtration device
Humans
intraocular pressure
Intraocular Pressure - physiology
Ophthalmology
postoperative complications
Prosthesis Implantation
Trabeculectomy
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Summary:Abstract Glaucoma filtration surgery is performed to reduce intraocular pressure (IOP) in patients for whom maximal tolerable pharmacologic IOP-lowering therapy and/or laser surgery fail to lower IOP sufficiently and/or fail to prevent optic nerve damage or visual field deterioration. For decades, the most widely utilized procedure for glaucoma filtration surgery has been trabeculectomy. Although this approach reliably provides long-term IOP reduction in many patients, the postoperative complication rate is high. This has driven the development of alternative approaches to reduce IOP surgically. The EX-PRESS glaucoma filtration device was developed to mimic IOP control by trabeculectomy and to have a better safety profile. This non-valved, medical-grade stainless steel device diverts aqueous humor from the anterior chamber to an intrascleral space. Despite the widespread use of the EX-PRESS device, only a few studies compare its efficacy and safety with that of trabeculectomy. We analyze available data regarding the safety and efficacy of the EX-PRESS device, particularly in comparison with trabeculectomy.
ISSN:0039-6257
1879-3304
DOI:10.1016/j.survophthal.2015.01.001