Article Text

other Versions

PDF
Comparison of trabeculectomy versus Ex-PRESS: 3-year follow-up
  1. Johanna M Gonzalez-Rodriguez1,
  2. Graham E Trope1,
  3. Lilach Drori-Wagschal1,
  4. Delan Jinapriya2,
  5. Yvonne M Buys1
  1. 1Department of Ophthalmology and Vision Sciences, Toronto Western Hospital/University of Toronto, Toronto, Ontario, Canada
  2. 2Department of Ophthalmology, Queen's University, Kingston, Ontario, Canada
  1. Correspondence to Dr Yvonne M Buys, Department of Ophthalmology and Vision Sciences, Toronto Western Hospital, 399 Bathurst St, EW 6-405, Toronto, Ontario, Canada M5T 2S8; y.buys{at}utoronto.ca

Abstract

Aims To compare the outcomes of Ex-PRESS versus trabeculectomy at 3 years.

Methods Consenting patients aged 18–85 years with medically uncontrolled open-angle glaucoma scheduled for trabeculectomy were included in this study. 63 subjects were randomised to undergo Ex-PRESS (32) or trabeculectomy (31). Follow-up data included intraocular pressure (IOP), glaucoma medications, visual acuity (VA), complications and additional interventions. Complete success was defined as IOP between 5 and 18 mm Hg and 20% reduction from baseline without glaucoma medications, while qualified success was with or without glaucoma medications.

Results Complete success at 2 and 3 years was 43% vs 42% (p=0.78) and 35% vs 38% (p=0.92) in Ex-PRESS versus trabeculectomy, respectively. Qualified success at 2 and 3 years was 59% vs 76% (p=0.20) and 52% vs 61% (p=0.43) in Ex-PRESS versus trabeculectomy, respectively. Mean IOP at 2 and 3 years was 12.5±5.1 mm Hg vs 10.3±3.7 mm Hg (p=0.07) and 13.3±4.5 mm Hg vs 11.1±4.4 mm Hg (p=0.10) for Ex-PRESS versus trabeculectomy, respectively. At 3 years, 47.6% of Ex-PRESS and 50% of trabeculectomy patients were on glaucoma medications (p=1.00). No difference in VA was found after 3 years (logarithm of minimum angle of resolution 0.43±0.4 vs 0.72±0.8 for Ex-PRESS vs trabeculectomy, p=0.11). When excluding patients who underwent reoperation VA was better in the Ex-PRESS group at 1, 2 and 3 years. There were no complications after the first year in either group.

Conclusions We found no difference in success rates, mean IOP or other secondary outcomes between Ex-PRESS and trabeculectomy after 3 years of follow-up.

Trial registration number NCT01263561; post results.

  • Glaucoma
  • Intraocular pressure
  • Treatment Surgery

Statistics from Altmetric.com

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Linked Articles

  • At a glance
    Keith Barton James Chodosh Jost Jonas