Glaucoma Service, Wills Eye Institute, Philadelphia, Pennsylvania 19107, USA.
Clin Exp Ophthalmol. 2011 Jul;39(5):421-8. doi: 10.1111/j.1442-9071.2010.02481.x. Epub 2011 Feb 23.
To report the safety and efficacy of Ex-PRESS(TM) miniature glaucoma implant under a scleral flap in patients with previous ocular surgeries.
Retrospective, non-comparative case series from a tertiary care hospital.
Patients with previous cataract or failed glaucoma surgeries who had undergone implantation of the Ex-PRESS(TM) miniature glaucoma implant (R-50 and T-50), under a scleral flap, with a minimum of 1-year postoperative follow up.
For postoperative outcome, success was defined as complete if intraocular pressure (IOP) was 5-21 mmHg without medication or surgical intervention, and qualified if intraocular pressure was within the same range with glaucoma medication. To compare the outcome between patients who had previous trabeculectomy or cataract surgery the definition of success was intraocular pressure of 5-15 mmHg.
Intraocular pressure, number of antiglaucoma drugs, visual acuity and complications.
One hundred eyes (100 patients; mean age: 77.4 years) with a mean follow-up period of 27 ± 13.2 months (range: 12-66) were considered. Success was complete in 60 (60%) and qualified in 24 (24%) eyes. The mean preoperative IOP of 27.7 ± 9.2 mmHg (range: 14-52 mmHg) with 2.73 ± 1.1 drugs declined to 14.02 ± 5.1 mmHg with 0.72 ± 1.06 drugs at the last follow up (P < 0.0001). Causes of failure were uncontrolled intraocular pressure (11%), bleb needling (4%) and persistent hypotony (1%). The probability of success in the patients with previous cataract surgery and trabeculectomy at 3 years was 60.6% and 50.9%, respectively.
The Ex-PRESS(TM) implant under scleral flap was a safe and effective glaucoma surgery in the eyes with prior ocular surgery.
报告在先前眼手术患者中经巩膜瓣施行 Ex-PRESS(TM)微型青光眼植入物的安全性和疗效。
来自三级保健医院的回顾性、非对照病例系列研究。
既往白内障或青光眼手术失败而接受 Ex-PRESS(TM)微型青光眼植入物（R-50 和 T-50）经巩膜瓣植入，术后至少有 1 年随访的患者。
术后结果，完全成功定义为眼压（IOP）在 5-21mmHg 无需药物或手术干预，合格成功定义为IOP 在相同范围内使用抗青光眼药物。为了比较既往小梁切除术或白内障手术患者的结果，成功的定义为眼压 5-15mmHg。
眼压、抗青光眼药物的数量、视力和并发症。
共纳入 100 只眼（100 例患者；平均年龄：77.4 岁），平均随访时间为 27±13.2 个月（范围：12-66）。完全成功 60 只眼（60%），合格成功 24 只眼（24%）。术前平均 IOP 为 27.7±9.2mmHg（范围：14-52mmHg），使用 2.73±1.1 种药物，最后一次随访时 IOP 降至 14.02±5.1mmHg，使用 0.72±1.06 种药物（P<0.0001）。失败的原因是眼压控制不佳（11%）、滤过泡穿刺（4%）和持续性低眼压（1%）。既往白内障手术和小梁切除术患者 3 年时的成功率分别为 60.6%和 50.9%。
经巩膜瓣施行 Ex-PRESS(TM)植入物是先前眼手术患者安全有效的青光眼手术。
