Comparison of trabeculectomy and Ex-PRESS implantation in fellow eyes of the same patient: a prospective, randomised study

Purpose To compare intraocular pressure (IOP) over time after standard trabeculectomy vs Ex-PRESS implantation in patients with bilateral primary open-angle glaucoma (POAG). Design Prospective, randomised study. Patients and methods This study included adult patients with bilateral POAG necessitatin...

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Bibliographic Details
Published in:Eye (London) 2012-05, Vol.26 (5), p.703-710
Main Authors: Dahan, E, Ben Simon, G J, Lafuma, A
Format: Article
Language:English
Subjects:
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Aged
Antihypertensive Agents - administration & dosage
Biological and medical sciences
Clinical Study
Eye
Female
Follow-Up Studies
Glaucoma
Glaucoma and intraocular pressure
Glaucoma Drainage Implants
Glaucoma, Open-Angle - physiopathology
Glaucoma, Open-Angle - surgery
Humans
Intraocular Pressure - physiology
Laboratory Medicine
Male
Mathematical models
Medical sciences
Medicine
Medicine & Public Health
Miscellaneous
Ophthalmology
Pharmaceutical Sciences/Technology
Postoperative Complications
Pressure
Proportional Hazards Models
Prospective Studies
Prosthesis Implantation
Statistical analysis
Surgery
Surgical Flaps
Surgical Oncology
Survival
Tonometry, Ocular
Trabeculectomy
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Summary:Purpose To compare intraocular pressure (IOP) over time after standard trabeculectomy vs Ex-PRESS implantation in patients with bilateral primary open-angle glaucoma (POAG). Design Prospective, randomised study. Patients and methods This study included adult patients with bilateral POAG necessitating surgery. Each patient underwent trabeculectomy in one eye and Ex-PRESS implantation under a scleral flap in the other eye according to randomised contralateral allocations. Efficacy was assessed by IOP values and success rates (IOP threshold and/or need for topical glaucoma medication) during 30 months. Statistical analysis included Generalised Estimate Equation and Cox Survival models, and paired t -tests. Results Thirty eyes of 15 patients were studied for a mean of 23.6 months (SD, ±6.9). At the last follow-up visit, mean pre-operative IOP decreased from 31.1 (±14.2) to 16.2 (±1.5) mm Hg after trabeculectomy, and from 28.1 (±9.0) to 15.7 (±1.8) mm Hg after Ex-PRESS implantation ( P =0.001). The mean number of anti-glaucoma medicines prescribed at the last follow-up decreased from 3.7 pre-operatively (both groups) to 0.9 after trabeculectomy vs 0.3 after Ex-PRESS implantation ( P =0.001). Complete success rates (5
ISSN:0950-222X
1476-5454
DOI:10.1038/eye.2012.13