Trabeculectomy Versus Ex-Press Glaucoma Filtration Device in Silicomacrophagocytic Open Angle Glaucoma Secondary to Silicone Oil Emulsification.

Abstract

PURPOSE:

To compare the outcomes of Ex-PRESS device implantation versus trabeculectomy in patients with ocular hypertension after pars plana vitrectomy and silicone oil injection (SOI).

MATERIALS AND METHODS:

Twenty-six consecutive eyes with ocular hypertension after pars plana vitrectomy and SOI were included in this study and randomized to one of two groups: A group treated with Ex-PRESS (model P50) placed under a scleral flap (Ex-PRESS group), and a group treated with trabeculectomy (trabeculectomy group). Complete success (intraocular pressure [IOP] <21 mmHg without medication) and qualified success rates (IOP <21 mmHg with one or two glaucoma medications) at 2 years postoperatively were analyzed. Between-groups comparison was performed with the Mann-Whitney U-test for continuous variables, and Fischer exact test for categorical data. Success rates between groups were compared using Kaplan-Meier life analysis and the log-rank test. P < 0.05 was considered statistically significant.

RESULTS:

In the Ex-PRESS group, complete success was achieved in 73% eyes and qualified success in 81.8% of eyes. In the trabeculectomy group, complete success was achieved in 40% and qualified success was achieved in 60% of eyes. The difference in mean IOP between groups was statistically significant from the 3(rd) postoperative month onward (P = 0.007 at 3 months, P = 0.003 at 6 months, and P = 0.03 at 24 months).

CONCLUSION:

Ex-PRESS implantation was more effective than trabeculectomy in controlling IOP in ocular hypertensives after pars plana vitrectomy and SOI, but the surgical technique may require improvement.

• Authors: Donato Errico, Francesca Luigia Scrimieri, Roberta Riccardi, Giancarlo Iarossi
• Journal: Middle East African journal of ophthalmology (Middle East Afr J Ophthalmol) 2016 Apr-Jun Vol. 23 Issue 2 Pg. 177-82 ISSN: 0975-1599 [Electronic] India
• PMID: 27162449 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial)

Chemical References

• Emulsions
• Silicone Oils

Topics

• Adult
• Aged
• Emulsions
• Endotamponade (adverse effects)
• Female
• Glaucoma Drainage Implants
• Glaucoma, Open-Angle (etiology, surgery)
• Humans
• Intraocular Pressure (physiology)
• Male
• Middle Aged
• Silicone Oils
• Tonometry, Ocular
• Trabeculectomy (methods)
• Vitrectomy
• Vitreoretinal Surgery