ABSTRACT
@#AIM:To study the effect of EX-PRESS miniature glaucoma device implantation on corneal endothelial cell density and intraocular pressure for primary open angle glaucoma(POAG). <p>METHODS:This was a prospective clinical study of 38 eyes in 32 POAG patients who underwent EX-PRESS miniature glaucoma device implantation in our hospital from May 2016 to December 2017. The central, nasal, temporal,superior, inferior endothelium cell density, intraocular pressure(IOP), best corrected visual acuity(BCVA)were observed at 24mo after operation. Anterior chamber depth and the position of drainage nail with iris and cornea were also observed. <p>RESULTS: There was no significant difference of the corneal endothelium density in five sites and BCVA between preoperation and postoperation(<i>P</i>>0.05). There was significant difference in IOP between pre-operation and postoperation(<i>P</i><0.05). The complete success rate was 66% and conditional success rate was 21%, the failure rate was 13%. The main cause of failure was filtering bleb scarring. There was no complete disappearance of anterior chamber during the operation and follow-up period. There were 1 eye of shallow anterior chamber, 5 eyes of EX-PRESS contact with iris surface. The position of drainage nail with iris and cornea endothelium was good in the other 32 eyes.<p>CONCLUSION: The EX-PRESS miniature glaucoma device implantation has no effect on corneal endothelial cells in five directions and can effectively control intraocular pressure. It is a safe and effective method for primary open-angle glaucoma.
ABSTRACT
@#AIM: To observe the clinical efficacy and safety of the Ex-press miniature glaucoma device placed under scleral flap combined mitomycin C for the treatment of refractory glaucoma. <p>METHODS: This retrospective analysis comprised 18 eyes of 18 patients who suffered from refractory glaucoma and treated with Ex-press miniature glaucoma device implantation combined mitomycin C in January 2014 to May 2015 in Jingzhou Central Hospital. All patients were followed at least 12mo. The visual acuity, intraocular pressure(IOP), complications and filtering bleb were recorded and statistically analyzed preoperative and 1d, 1, 2wk, 1, 6 and 12mo after operation. <p>RESULTS: Average intraocular pressure was 43.83±7.99mmHg preoperative and decreased significantly at every time point postoperative(8.72±3.29, 11.56±1.86, 13.33±2.30, 13.67±2.03, 14.78±3.64, 16.61±7.19mmHg respectively), the difference was statistically significant(<i>t</i>=16.475, 15.324, 14.761, 14.172, 12.140, 11.412, <i>P</i><0.05). The successful rate was 89% at 12mo after operation, and 3 eyes with improved vision, 12 eyes with unchanged vision, 3 eyes with decreased vision. Early complications were mainly anterior chamber bleeding and postoperative shallow anterior chamber, and late complications were non-functional bleb. There were no serious or unexpected complications in our group of patients. <p>CONCLUSION:The Ex-press miniature glaucoma device implantation combined mitomycin C in the treatment of refractory glaucoma is a safe and effective method, which has few surgical complications and less damage to eyesight, and make the stability control of postoperative intraocular pressure.