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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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| Published in: | Eye (London) 2012-05, Vol.26 (5), p.703-710 |
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| creator | Dahan, E Ben Simon, G J Lafuma, A |
| description | 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 |
| doi_str_mv | 10.1038/eye.2012.13 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_3351049</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1012747267</sourcerecordid><originalsourceid>FETCH-LOGICAL-c509t-322332cc2dc46636b799863b016dfb07d71cd992ed1cd1aec3dc50880e82ae843</originalsourceid><addsrcrecordid>eNqFkc1v1DAQxS0EotvCiTuyhJAq0Sz-jGMOSGi1fEiVQBQkbpbXcVpXSZzaSWH565mwSylw4DSH-c2befMQekTJkhJePfdbv2SEsiXld9CCClUWUkhxFy2IlqRgjH05QIc5XxICTUXuowPGuBC00gv0fRW7waaQY49jg8dkN95NrXdj7LbY9jVefys-fFyfneHQDa3tRzsGYEOPG9-28SuG9fnn6IXH2XYeD0D4fnyBLR5SzANohWt_ghOoxS5kX-M8TvX2AbrX2Db7h_t6hD6_Xn9avS1O3795t3p1WjhJ9FhwOJYz51jtRFnycqO0rkq-IbSsmw1RtaKu1pr5Giq13vEaBquK-IpZXwl-hF7udIdp0_nawW3JtmZIobNpa6IN5s9OHy7Mebw2nEtKhAaB471AileTz6MBFw7c297HKRvKpFKCS13-H4WclFCsVIA--Qu9jFPq4RMzRTWXnMy7n-0oB6_MyTc3d1Ni5vgN_N_M8RvKgX582-oN-ytvAJ7uAZudbRvIxIX8m5NVJYicfZzsuAyt_tyn28f9u_cHuRHH8A</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1011935309</pqid></control><display><type>article</type><title>Comparison of trabeculectomy and Ex-PRESS implantation in fellow eyes of the same patient: a prospective, randomised study</title><source>PubMed Central Free</source><creator>Dahan, E ; Ben Simon, G J ; Lafuma, A</creator><creatorcontrib>Dahan, E ; Ben Simon, G J ; Lafuma, A</creatorcontrib><description>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<IOP<18 mm Hg without medications) were higher with Ex-PRESS compared with trabeculectomy (
P
=0.0024). Postoperative complications were more frequent after trabeculectomy (33%) compared with Ex-PRESS (20%), with four trabeculectomy eyes (27%) needing postoperative interventions, compared with none with Ex-PRESS.
Conclusions
Trabeculectomy and Ex-PRESS implantation provided similar IOP control, but the Ex-PRESS group had a lower rate of complications, fewer postoperative interventions, and needed less glaucoma medications.</description><identifier>ISSN: 0950-222X</identifier><identifier>EISSN: 1476-5454</identifier><identifier>DOI: 10.1038/eye.2012.13</identifier><identifier>PMID: 22344189</identifier><identifier>CODEN: EYEEEC</identifier><language>eng</language><publisher>London: Nature Publishing Group UK</publisher><subject>692/699 ; 692/700/565/545 ; 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</subject><ispartof>Eye (London), 2012-05, Vol.26 (5), p.703-710</ispartof><rights>Royal College of Ophthalmologists 2012</rights><rights>2015 INIST-CNRS</rights><rights>Copyright Nature Publishing Group May 2012</rights><rights>Copyright © 2012 Royal College of Ophthalmologists 2012 Royal College of Ophthalmologists</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c509t-322332cc2dc46636b799863b016dfb07d71cd992ed1cd1aec3dc50880e82ae843</citedby><cites>FETCH-LOGICAL-c509t-322332cc2dc46636b799863b016dfb07d71cd992ed1cd1aec3dc50880e82ae843</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3351049/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3351049/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=25884056$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22344189$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Dahan, E</creatorcontrib><creatorcontrib>Ben Simon, G J</creatorcontrib><creatorcontrib>Lafuma, A</creatorcontrib><title>Comparison of trabeculectomy and Ex-PRESS implantation in fellow eyes of the same patient: a prospective, randomised study</title><title>Eye (London)</title><addtitle>Eye</addtitle><addtitle>Eye (Lond)</addtitle><description>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<IOP<18 mm Hg without medications) were higher with Ex-PRESS compared with trabeculectomy (
P
=0.0024). Postoperative complications were more frequent after trabeculectomy (33%) compared with Ex-PRESS (20%), with four trabeculectomy eyes (27%) needing postoperative interventions, compared with none with Ex-PRESS.
Conclusions
Trabeculectomy and Ex-PRESS implantation provided similar IOP control, but the Ex-PRESS group had a lower rate of complications, fewer postoperative interventions, and needed less glaucoma medications.</description><subject>692/699</subject><subject>692/700/565/545</subject><subject>Aged</subject><subject>Antihypertensive Agents - administration & dosage</subject><subject>Biological and medical sciences</subject><subject>Clinical Study</subject><subject>Eye</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Glaucoma</subject><subject>Glaucoma and intraocular pressure</subject><subject>Glaucoma Drainage Implants</subject><subject>Glaucoma, Open-Angle - physiopathology</subject><subject>Glaucoma, Open-Angle - surgery</subject><subject>Humans</subject><subject>Intraocular Pressure - physiology</subject><subject>Laboratory Medicine</subject><subject>Male</subject><subject>Mathematical models</subject><subject>Medical sciences</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Miscellaneous</subject><subject>Ophthalmology</subject><subject>Pharmaceutical Sciences/Technology</subject><subject>Postoperative Complications</subject><subject>Pressure</subject><subject>Proportional Hazards Models</subject><subject>Prospective Studies</subject><subject>Prosthesis Implantation</subject><subject>Statistical analysis</subject><subject>Surgery</subject><subject>Surgical Flaps</subject><subject>Surgical Oncology</subject><subject>Survival</subject><subject>Tonometry, Ocular</subject><subject>Trabeculectomy</subject><issn>0950-222X</issn><issn>1476-5454</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><recordid>eNqFkc1v1DAQxS0EotvCiTuyhJAq0Sz-jGMOSGi1fEiVQBQkbpbXcVpXSZzaSWH565mwSylw4DSH-c2befMQekTJkhJePfdbv2SEsiXld9CCClUWUkhxFy2IlqRgjH05QIc5XxICTUXuowPGuBC00gv0fRW7waaQY49jg8dkN95NrXdj7LbY9jVefys-fFyfneHQDa3tRzsGYEOPG9-28SuG9fnn6IXH2XYeD0D4fnyBLR5SzANohWt_ghOoxS5kX-M8TvX2AbrX2Db7h_t6hD6_Xn9avS1O3795t3p1WjhJ9FhwOJYz51jtRFnycqO0rkq-IbSsmw1RtaKu1pr5Giq13vEaBquK-IpZXwl-hF7udIdp0_nawW3JtmZIobNpa6IN5s9OHy7Mebw2nEtKhAaB471AileTz6MBFw7c297HKRvKpFKCS13-H4WclFCsVIA--Qu9jFPq4RMzRTWXnMy7n-0oB6_MyTc3d1Ni5vgN_N_M8RvKgX582-oN-ytvAJ7uAZudbRvIxIX8m5NVJYicfZzsuAyt_tyn28f9u_cHuRHH8A</recordid><startdate>20120501</startdate><enddate>20120501</enddate><creator>Dahan, E</creator><creator>Ben Simon, G J</creator><creator>Lafuma, A</creator><general>Nature Publishing Group UK</general><general>Nature Publishing Group</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>7QO</scope><scope>8FD</scope><scope>FR3</scope><scope>P64</scope><scope>5PM</scope></search><sort><creationdate>20120501</creationdate><title>Comparison of trabeculectomy and Ex-PRESS implantation in fellow eyes of the same patient: a prospective, randomised study</title><author>Dahan, E ; Ben Simon, G J ; Lafuma, A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c509t-322332cc2dc46636b799863b016dfb07d71cd992ed1cd1aec3dc50880e82ae843</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>692/699</topic><topic>692/700/565/545</topic><topic>Aged</topic><topic>Antihypertensive Agents - administration & dosage</topic><topic>Biological and medical sciences</topic><topic>Clinical Study</topic><topic>Eye</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Glaucoma</topic><topic>Glaucoma and intraocular pressure</topic><topic>Glaucoma Drainage Implants</topic><topic>Glaucoma, Open-Angle - physiopathology</topic><topic>Glaucoma, Open-Angle - surgery</topic><topic>Humans</topic><topic>Intraocular Pressure - physiology</topic><topic>Laboratory Medicine</topic><topic>Male</topic><topic>Mathematical models</topic><topic>Medical sciences</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Miscellaneous</topic><topic>Ophthalmology</topic><topic>Pharmaceutical Sciences/Technology</topic><topic>Postoperative Complications</topic><topic>Pressure</topic><topic>Proportional Hazards Models</topic><topic>Prospective Studies</topic><topic>Prosthesis Implantation</topic><topic>Statistical analysis</topic><topic>Surgery</topic><topic>Surgical Flaps</topic><topic>Surgical Oncology</topic><topic>Survival</topic><topic>Tonometry, Ocular</topic><topic>Trabeculectomy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Dahan, E</creatorcontrib><creatorcontrib>Ben Simon, G J</creatorcontrib><creatorcontrib>Lafuma, A</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biological Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>Biotechnology Research Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Eye (London)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Dahan, E</au><au>Ben Simon, G J</au><au>Lafuma, A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Comparison of trabeculectomy and Ex-PRESS implantation in fellow eyes of the same patient: a prospective, randomised study</atitle><jtitle>Eye (London)</jtitle><stitle>Eye</stitle><addtitle>Eye (Lond)</addtitle><date>2012-05-01</date><risdate>2012</risdate><volume>26</volume><issue>5</issue><spage>703</spage><epage>710</epage><pages>703-710</pages><issn>0950-222X</issn><eissn>1476-5454</eissn><coden>EYEEEC</coden><abstract>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<IOP<18 mm Hg without medications) were higher with Ex-PRESS compared with trabeculectomy (
P
=0.0024). Postoperative complications were more frequent after trabeculectomy (33%) compared with Ex-PRESS (20%), with four trabeculectomy eyes (27%) needing postoperative interventions, compared with none with Ex-PRESS.
Conclusions
Trabeculectomy and Ex-PRESS implantation provided similar IOP control, but the Ex-PRESS group had a lower rate of complications, fewer postoperative interventions, and needed less glaucoma medications.</abstract><cop>London</cop><pub>Nature Publishing Group UK</pub><pmid>22344189</pmid><doi>10.1038/eye.2012.13</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Eye (London), 2012-05, Vol.26 (5), p.703-710 |
| issn | 0950-222X 1476-5454 |
| language | eng |
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| source | PubMed Central Free |
| subjects | 692/699 692/700/565/545 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 |
| title | Comparison of trabeculectomy and Ex-PRESS implantation in fellow eyes of the same patient: a prospective, randomised study |
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