Twelve-month efficacy and safety of glaucoma filtration device for surgery in patients with normal-tension glaucoma

• Published in: Japanese journal of ophthalmology 2019-09, Vol.63 (5), p.402-409
• Main Authors: Aihara, Makoto, Kuwayama, Yasuaki, Miyata, Kazunori, Ohtani, Shinichiro, Ideta, Ryuichi, Hashimoto, Yoshihiro, Sasaki, Noriyuki, Shirato, Shiroaki
• Format: Article
• Language: English
• Subjects: Cataracts; Cell density; Clinical Investigation; Cornea; Density; Effectiveness; Endothelial cells; Eye; Eye surgery; Female; Filtering Surgery - methods; Filtration; Follow-Up Studies; Glaucoma; Glaucoma Drainage Implants; Humans; Implantation; Intraocular pressure; Intraocular Pressure - physiology; Low Tension Glaucoma - physiopathology; Low Tension Glaucoma - surgery; Male; Medicine; Medicine & Public Health; Middle Aged; Ophthalmology; Prospective Studies; Reduction; Safety; Surgery; Time Factors; Treatment Outcome; Visual Acuity
• ISSN: 0021-5155; 1613-2246
• DOI: 10.1007/s10384-019-00682-7

Purpose To assess the efficacy and safety of filtration surgery using the EX-PRESS glaucoma filtration device in patients with normal-tension glaucoma (NTG). Study design Prospective, single-arm, multicenter interventional case series. Methods Eyes with NTG underwent EX-PRESS implantation with or without cataract surgery. The efficacy and safety were assessed at 1 day; 1 and 2 weeks; and 1, 3, 6, and 12 months after surgery. The main outcome measure was reduction in intraocular pressure (IOP) from baseline at 3, 6, and 12 months after surgery. Safety assessments included adverse event incidence, postoperative inflammation, and corneal endothelial cell density. Results Thirty-two Japanese patients (37 eyes) with NTG were enrolled. The mean IOP decreased from 14.8 ± 2.3 mmHg at baseline to 10.0 ± 3.1 mmHg at 12 months after surgery (mean reduction 4.9 ± 4.2 mmHg [31.1%]; P   20% were achieved by 61.5% of the eyes at 12 months. Adverse events were typical for filtration procedures, and none was deemed device-related. Postoperative inflammation was mild and self-limiting. The mean corneal endothelial cell density had decreased by 3.3% at 12 months after surgery. Conclusion The EX-PRESS glaucoma filtration device is safe and effective for filtration surgery in patients with NTG, providing mean IOP reduction consistent with recommendations based on the Collaborative NTG Study.