Wagdy Faried Mohammed, Zaky Adel Galal
Ophthalmology Department, Faculty of Medicine, Menoufia University, Shebeen El-Kom, Egypt.
J Ophthalmol. 2020 May 17;2020:3781249. doi: 10.1155/2020/3781249. eCollection 2020.
To compare the outcomes of Ex-PRESS glaucoma filtration device and transscleral cyclophotocoagulation (TSCP) in the management of neovascular glaucoma (NVG). . A total of 30 eyes (12 express shunts and 18 TSCP) of 28 patients were included. The eyes had NVG with intraocular pressure (IOP) more than 21 mmHg of the maximally tolerated medication treatment after previous panretinal photocoagulation and antivascular endothelial growth factor (anti-VEGF) injection, with no previous history of a cyclodestruction procedure or glaucoma surgery, were randomized either for Ex-PRESS glaucoma filtration device or TSCP. The patients were followed up weekly for the first month and then monthly for 12 months as regard to the IOP, number of topical antiglaucoma drugs required, visual outcome, and postoperative complications.
IOP was successfully controlled with both techniques in 83.3% of the eyes. Both techniques had fewer complications and required fewer subsequent procedures.
Both the Ex-PRESS glaucoma filtration device and TSCP might constitute safe and alternative therapeutic tools for patients with NVG. However, TSCP is an easier procedure, less time consuming, and does not require a learning curve.
比较Ex-PRESS青光眼引流装置和经巩膜睫状体光凝术（TSCP）治疗新生血管性青光眼（NVG）的效果。纳入28例患者的30只眼（12只植入Ex-PRESS分流器，18只接受TSCP）。这些眼睛患有NVG，在先前进行全视网膜光凝和抗血管内皮生长因子（抗VEGF）注射后，使用最大耐受药物治疗时眼压（IOP）仍超过21 mmHg，且既往无睫状体破坏手术或青光眼手术史，被随机分为接受Ex-PRESS青光眼引流装置或TSCP治疗。在第一个月每周对患者进行随访，之后12个月每月随访，观察眼压、所需局部抗青光眼药物数量、视力结果和术后并发症。
两种技术均成功控制了83.3%的眼睛的眼压。两种技术的并发症均较少，后续所需手术也较少。
Ex-PRESS青光眼引流装置和TSCP对NVG患者可能都是安全的替代治疗工具。然而，TSCP操作更简便，耗时更少，且无需学习曲线。
