Glaucoma sector, University of Geneva, Geneva, Switzerland.
Discipline of Ophthalmology, University of Sydney, Sydney, Australia.
Surv Ophthalmol. 2015 Jul-Aug;60(4):327-45. doi: 10.1016/j.survophthal.2015.01.001. Epub 2015 Jan 24.
Glaucoma filtration surgery is performed to reduce intraocular pressure (IOP) in patients for whom maximal tolerable pharmacologic IOP-lowering therapy and/or laser surgery fail to lower IOP sufficiently and/or fail to prevent optic nerve damage or visual field deterioration. For decades, the most widely utilized procedure for glaucoma filtration surgery has been trabeculectomy. Although this approach reliably provides long-term IOP reduction in many patients, the postoperative complication rate is high. This has driven the development of alternative approaches to reduce IOP surgically. The EX-PRESS glaucoma filtration device was developed to mimic IOP control by trabeculectomy and to have a better safety profile. This non-valved, medical-grade stainless steel device diverts aqueous humor from the anterior chamber to an intrascleral space. Despite the widespread use of the EX-PRESS device, only a few studies compare its efficacy and safety with that of trabeculectomy. We analyze available data regarding the safety and efficacy of the EX-PRESS device, particularly in comparison with trabeculectomy.
青光眼滤过性手术是为了降低眼压（IOP）而进行的，适用于那些对最大耐受的药物降眼压治疗和/或激光手术不能充分降低眼压，或不能预防视神经损伤或视野恶化的患者。几十年来，最广泛应用于青光眼滤过性手术的方法是小梁切除术。尽管这种方法在许多患者中可靠地提供了长期的眼压降低，但术后并发症发生率很高。这促使人们开发替代方法来通过手术降低眼压。EX-PRESS 青光眼滤过装置的开发旨在模拟小梁切除术对眼压的控制，并具有更好的安全性。这种无瓣膜、医用级不锈钢装置将房水从前房引流到巩膜内间隙。尽管 EX-PRESS 装置广泛应用，但只有少数研究比较了其与小梁切除术的疗效和安全性。我们分析了关于 EX-PRESS 装置安全性和疗效的现有数据，特别是与小梁切除术的比较。
