The clinical outcome and complications of Ex-PRESS glaucoma shunt implantation / 中国医师杂志

ABSTRACT

Objective To report operative course and relative complications in a group of patients who underwent Excessive Pressure Regulation System (Ex-PRESS) glaucoma shunt implantation in the real world,and discuss the ralated factors and possible interventions in clinical practice.Methods Preferred Ex-PRESS glaucoma shunt implantation were performed on 11 eyes with deverse types of glaucoma.Operative course and relative complications were analyzed from recorded tapes and documents.The correlations between complications,types of glaucoma,and previous procedures were analyzed,the complications were appropriately managed.Results 11 patients with diverse types of glaucoma who underwent Ex-PRESS glaucoma shunt implantation were recruited for the study.Among them,2 patients had combined phacoemulcification surgery,1 patient had repeat shunt implantation.During the procedure,1 patient had dislocated shunt into anterior chamber;1 patient had shunt entirely inserted into anterior chamber with plunger.4 patients had hypotony and flat anterior chamber,2 of them had hyphema,2 experienced subchoroid detachment.1 patient had intraocular lens pupil clamping after combined cataract and glaucoma surgery;4 cases had flat filtering blebs and uncontrolled intraocular pressure during the follow-up period,2 of them had blocked drainage and proliferative anterior synechia around the head,which was found in the patients with primary angle-closure glaucoma who had previous operation history.The common long-term complication was external ostium occlusion (4/11).The complications of drainage are related to the type of glaucoma and the history of operation.Conclusions Other than the complications which present commonly in trabeculectomy procedure,there were some complications related to the Ex-PRESS glaucoma shunt.History of ocular surgery,surgical techniques and the type of disease were associated with the incidence of complications.