Department of Ophthalmology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan.
Int Ophthalmol. 2023 Aug;43(8):2803-2809. doi: 10.1007/s10792-023-02678-2. Epub 2023 Mar 4.
To compare surgical outcomes of Ex-PRESS® (EXP) surgery for primary open-angle glaucoma (POAG) between low preoperative intraocular pressure (IOP) and high preoperative IOP.
This was a retrospective non-randomized study. Seventy-nine POAG patients who underwent EXP surgery and were followed for > 3 years were included. Patients with a preoperative IOP of ≦ 16 mmHg and > 16 mmHg with tolerant glaucoma medications were defined as the low IOP group and the high IOP group, respectively. We compared the surgical outcomes, postoperative IOP and number of glaucoma medications. Success was defined as a postoperative IOP of ≦ 15 mmHg and a reduction of > 20% from the preoperative IOP to the postoperative IOP.
EXP surgeries significantly decreased IOPs from 13.2 ± 2.0 to 9.1 ± 2.9 mmHg in the low IOP group (p < 0.001), and from 22.5 ± 4.8 to 12.5 ± 4.0 mmHg in the high IOP group (p < 0.001). The mean postoperative IOP was significantly low in the low IOP group at 3 years (p = 0.0008). Success rates compared using the Kaplan-Meier survival curve were not significantly different (p = 0.449).
EXP surgery was useful for POAG patients with a low preoperative IOP.
比较低术前眼压和高术前眼压原发性开角型青光眼（POAG）患者 Ex-PRESS®（EXP）手术的手术结果。
这是一项回顾性非随机研究。纳入了 79 例接受 EXP 手术且随访时间超过 3 年的 POAG 患者。术前眼压≦16mmHg 和术前眼压>16mmHg 且耐受降眼压药物的患者分别定义为低眼压组和高眼压组。我们比较了手术结果、术后眼压和降眼压药物的数量。成功定义为术后眼压≦15mmHg，且术后眼压较术前眼压降低>20%。
EXP 手术显著降低了低眼压组的眼压，从术前的 13.2±2.0mmHg 降至术后的 9.1±2.9mmHg（p<0.001），并降低了高眼压组的眼压，从术前的 22.5±4.8mmHg 降至术后的 12.5±4.0mmHg（p<0.001）。在第 3 年，低眼压组的平均术后眼压明显较低（p=0.0008）。使用 Kaplan-Meier 生存曲线比较的成功率没有显著差异（p=0.449）。
EXP 手术对术前眼压较低的 POAG 患者是有用的。
