Short-term outcomes after EX-PRESS implantation versus trabeculectomy alone in patients with neovascular glaucoma

Yoichiro Shinohara, Hideo Akiyama, Mikiya Magori, Shoji Kishi Department of Ophthalmology, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan Background: The purpose of this study was to investigate postoperative clinical outcomes in patients with neovascular glaucoma (NVG) who u...

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Autores principales:	Shinohara Y, Akiyama H, Magori M, Kishi S
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2017
Materias:	trabeculectomy EX-PRESS neovascular glaucoma surgery tube shunt Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/29245abc2d23411f88d643497476a753
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spelling	oai:doaj.org-article:29245abc2d23411f88d643497476a7532021-12-02T01:49:48ZShort-term outcomes after EX-PRESS implantation versus trabeculectomy alone in patients with neovascular glaucoma1177-5483https://doaj.org/article/29245abc2d23411f88d643497476a7532017-12-01T00:00:00Zhttps://www.dovepress.com/short-term-outcomes-after-ex-press-implantation-versus-trabeculectomy--peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Yoichiro Shinohara, Hideo Akiyama, Mikiya Magori, Shoji Kishi Department of Ophthalmology, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan Background: The purpose of this study was to investigate postoperative clinical outcomes in patients with neovascular glaucoma (NVG) who underwent trabeculectomy or EX-PRESS implantation and to identify predictors of successful EX-PRESS implantation. Methods: The study designed as a retrospective observational analysis and was set in a single tertiary center. Eighty-nine patients (89 eyes) with NVG, were treated using trabeculectomy alone (Trab group; n=39) or EX-PRESS implantation (EX group; n=50). All patients with a history of glaucoma surgery were excluded. The main outcome measures were postoperative intraocular pressure (IOP), visual acuity (VA), number of medications, complications, additional therapy, and success rate. Results: The mean follow-up duration was 4.6 months in the Trab group and 4.2 months in the EX group. There was no significant difference in IOP between the groups except at 1-month follow-up (P=0.045). The number of patients with early postoperative hypotony, a shallow anterior chamber, hyphema, or anterior chamber irrigation was significantly lower in the EX group than in the Trab group (P=0.016, 0.008, 0.019, and 0.014, respectively). The other outcomes, ie, VA, number of medications, and success rate, were similar between the two groups. In the EX group, the success rate was significantly lower in 15 patients with a history of vitrectomy compared to that in 35 patients without a history of vitrectomy (P=0.047). Conclusion: Implantation of an EX-PRESS device may be more effective and safer than trabeculectomy alone in patients with NVG. However, a history of vitrectomy may affect the surgical success rate when using EX-PRESS. Keywords: trabeculectomy, EX-PRESS, neovascular glaucoma, surgery, tube shuntShinohara YAkiyama HMagori MKishi SDove Medical PressarticletrabeculectomyEX-PRESSneovascular glaucomasurgerytube shuntOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 11, Pp 2207-2213 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	trabeculectomy EX-PRESS neovascular glaucoma surgery tube shunt Ophthalmology RE1-994
spellingShingle	trabeculectomy EX-PRESS neovascular glaucoma surgery tube shunt Ophthalmology RE1-994 Shinohara Y Akiyama H Magori M Kishi S Short-term outcomes after EX-PRESS implantation versus trabeculectomy alone in patients with neovascular glaucoma
description	Yoichiro Shinohara, Hideo Akiyama, Mikiya Magori, Shoji Kishi Department of Ophthalmology, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan Background: The purpose of this study was to investigate postoperative clinical outcomes in patients with neovascular glaucoma (NVG) who underwent trabeculectomy or EX-PRESS implantation and to identify predictors of successful EX-PRESS implantation. Methods: The study designed as a retrospective observational analysis and was set in a single tertiary center. Eighty-nine patients (89 eyes) with NVG, were treated using trabeculectomy alone (Trab group; n=39) or EX-PRESS implantation (EX group; n=50). All patients with a history of glaucoma surgery were excluded. The main outcome measures were postoperative intraocular pressure (IOP), visual acuity (VA), number of medications, complications, additional therapy, and success rate. Results: The mean follow-up duration was 4.6 months in the Trab group and 4.2 months in the EX group. There was no significant difference in IOP between the groups except at 1-month follow-up (P=0.045). The number of patients with early postoperative hypotony, a shallow anterior chamber, hyphema, or anterior chamber irrigation was significantly lower in the EX group than in the Trab group (P=0.016, 0.008, 0.019, and 0.014, respectively). The other outcomes, ie, VA, number of medications, and success rate, were similar between the two groups. In the EX group, the success rate was significantly lower in 15 patients with a history of vitrectomy compared to that in 35 patients without a history of vitrectomy (P=0.047). Conclusion: Implantation of an EX-PRESS device may be more effective and safer than trabeculectomy alone in patients with NVG. However, a history of vitrectomy may affect the surgical success rate when using EX-PRESS. Keywords: trabeculectomy, EX-PRESS, neovascular glaucoma, surgery, tube shunt
format	article
author	Shinohara Y Akiyama H Magori M Kishi S
author_facet	Shinohara Y Akiyama H Magori M Kishi S
author_sort	Shinohara Y
title	Short-term outcomes after EX-PRESS implantation versus trabeculectomy alone in patients with neovascular glaucoma
title_short	Short-term outcomes after EX-PRESS implantation versus trabeculectomy alone in patients with neovascular glaucoma
title_full	Short-term outcomes after EX-PRESS implantation versus trabeculectomy alone in patients with neovascular glaucoma
title_fullStr	Short-term outcomes after EX-PRESS implantation versus trabeculectomy alone in patients with neovascular glaucoma
title_full_unstemmed	Short-term outcomes after EX-PRESS implantation versus trabeculectomy alone in patients with neovascular glaucoma
title_sort	short-term outcomes after ex-press implantation versus trabeculectomy alone in patients with neovascular glaucoma
publisher	Dove Medical Press
publishDate	2017
url	https://doaj.org/article/29245abc2d23411f88d643497476a753
work_keys_str_mv	AT shinoharay shorttermoutcomesafterexpressimplantationversustrabeculectomyaloneinpatientswithneovascularglaucoma AT akiyamah shorttermoutcomesafterexpressimplantationversustrabeculectomyaloneinpatientswithneovascularglaucoma AT magorim shorttermoutcomesafterexpressimplantationversustrabeculectomyaloneinpatientswithneovascularglaucoma AT kishis shorttermoutcomesafterexpressimplantationversustrabeculectomyaloneinpatientswithneovascularglaucoma
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Short-term outcomes after EX-PRESS implantation versus trabeculectomy alone in patients with neovascular glaucoma

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