Short term efficacy of EX-PRESS filtration shunt implantation for open angle glaucoma.

OBJECTIVES

To observe the short-term efficacy of EX-PRESS filtration shunt implantation in the treatment of open angle glaucoma, and to analyze the safety and effectiveness of the surgical method.

METHODS

From April 2017 to January 2018, a total of 28 eyes of 17 open angle glaucoma patients in Xiangya Hospital of Central South University were screened. Among them, 16 eyes in the experimental group were treated with EX-PRESS filtration shunt (P200)implantation, and 12 eyes in the control group underwent trabeculectomy. Related examinations were performed in 1 day before operation, 1 day after operation, 1 week after operation, 1 month after operation and 3 months after operation, which included intraocular pressure (IOP), uncorrected visual acuity (UCVA) and best corrected visual acuity (BCVA), central anterior chamber depth (ACD), trabecular iris angle (TIA), the long axis of drainage nail and corneal endothelium angle (ACA), intraoperative and postoperative complications. Visual-related quality of life questionnaire was conducted and scored in 3 months after operation.

RESULTS

In the experimental group, the IOP in 1 day after operation, 1 week after operation and 1 month after operation was decreased significantly compared with that in 1 day before operation (all <0.05), but the IOP in 3 months after operation was not significantly decreased compared with that in 1 day before operation (>0.05). In the control group, the IOP in 1 week after operation, 1 month and 3 months after operation was decreased significantly with that of pre-operation (all <0.05), but the IOP in 1 day after operation was not significantly decreased compared with that in 1 day before operation (>0.05).The BCVA between the 2 groups was significantly different in 1 week after operation, 1 month and 3 months after operation compared with that in 1 day before operation (>0.05). The ACD in 1 day after operation, 1 week after operation, 1 month after operation and 3 months after operation was not significantly different compared with that in 1 day before operation (all >0.05). However, the ACD in 1 week after operation and 1 month after operation was significantly different in the control group compared with that in 1 day before operation (both <0.05). There was no significant change in the TIA in the 2 group compared with that in 1 day before operation (all >0.05). At different observed time after operation, there was no significant difference in the ACA (all >0.05). The correlation analysis of Pearson showed that there was a weak correlation between the ACA and the IOP (=0.286, <0.05). According to the standard of surgical success defined in this study, the success rate of experimental group was 81.25%, and the control group was 83.33%. There was no significant difference in the visual-related quality of life score between the experimental group and the control group (>0.05), but the mean value in the former was higher.

CONCLUSIONS

As a new type of anti-glaucoma surgery, the success rate of EX-PRESS filtration shunt implantation for 3-month follow-up is equivalent to that of classic trabeculectomy. The operation process is simple, and there is no significant change in the ACD before and after the operation in the period of 3-month follow-up. The stability of the anterior chamber is better. There is no significant correlation between the relative position of the shunt in the anterior chamber and the IOP. Compared with trabeculectomy, there is no significant difference in the visual-related quality of life.