ONE-YEAR FOLLOW-UP COMPARISION OF PHACO-EXPRESS SHUNT IN PRIMARY OPEN-ANGLE GLAUCOMA VERSUS PSEUDOEXFOLIATIVE GLAUCOMA

  • 28 junio, 2016
  • 2016
ONE-YEAR FOLLOW-UP COMPARISION OF PHACO-EXPRESS SHUNT IN PRIMARY OPEN-ANGLE GLAUCOMA VERSUS PSEUDOEXFOLIATIVE GLAUCOMA

ONE-YEAR FOLLOW-UP COMPARISION OF PHACO-EXPRESS SHUNT IN PRIMARY OPEN-ANGLE GLAUCOMA VERSUS PSEUDOEXFOLIATIVE GLAUCOMA 

Trabajo presentado en: 12th EGS Congress 2016
Autores: López-Caballero C, Sánchez-Sánchez C, Contreras I, Puerto-Hernández B, Oblanca N, Blázquez V.

Purpose

To compare the intraocular pressure (IOP) requirement of ocular hypotensive treatment and visual recovery after surgery at 1,3,6 and 12 months after surgery in eyes with primary open angle glaucoma (POAG) or pseudoexfoliative glaucoma (PXG) treated by Phaco-Express.

 

Methods

The records of all patients with POAG and PSX who had undergone combined cataract and Ex-press shunt device surgery in our centre between 2013 and 2015 were considered for inclusion. Inclusion criteria were Phaco-Express surgery and one-year follow-up period after surgery. Eyes with intraoperative complications were excluded. IOP and number of topical drugs were studied.

imagen 1 Phaco Express Shunt vs Pseudoexfolliative Glaucoma

 

Results

Sixteen eyes operated by Phaco-Express were included, 9 diagnosed with POAG and 7 with PXG. There were no statistically significant differences in age, IOP, number of pre-surgery treatments and visual acuity between both groups. Mean pre-surgical IOP in POAG group was 18.0± 6.5 mmHg and decreased by 11% at first month, 18% at third month, 22% at sixth months and 26% at one year after surgery (p<0.05 except for one month). Number of drugs needed before surgery was 3.4 ± 0.7 decreased to 0.4 ± 0.8, 0.8±1.1, 1.3±0.7 and 1.1±0.7 at one, three, six and twelve months after surgery.

Mean IOP in PXG group decreased from 19.5 ± 6.1 mmHg by 30%, 39%, 33% and 35% at one, three, six and twelve months post-surgery respectively (p<0.05 at six and twelve months)(Fig 1). Number of drugs decreased from 2.71 pre-surgery to 0.17 ± 0.48, 0.00, 0.33 ± 0.81 and 1.00 ±1.54 at 1, 3, 6 and 12 months respectively (Fig 2).

No statistically significant difference between groups was observed except for the number of hypotensive drops needed at 6 months after surgery: 1.3 in POAG vs 0.3 in PXG (p<0.05).

Fig 1. IOP (mmHg) in each group pre and postsurgical.

Fig 1. IOP (mmHg) in each group pre and postsurgical.

Fig 2. Number of hypotensive drugs used in each group pre and postsurgical.

Fig 2. Number of hypotensive drugs used in each group pre and postsurgical.


Conclusions

Combined Phaco-Express surgery is an excellent alternative for IOP control and achieves a reduction in hypotensive topical treatments a yearafter the intervention in POAG and PXG eyes

 

Bibliography

– Samková K, Rejmont L. Management of uncontrolled secondary glaucoma with ExPRESS glaucoma minishunt implantation. Cesk Slov Oftalmol. 2013 Oct;69(5):198-200..

-Wang X, Khan R, Coleman A. Device-modified trabeculectomy for glaucomaCochrane Database Syst Rev. 2015 Dec 1;(12):CD010472. doi: 10.1002/14651858.CD010472.pub2. Review.

-Gonzalez-Rodriguez JM, Trope GE, Drori-Wagschal L, Jinapriya D, Buys YM. Comparison of trabeculectomy versus Ex-PRESS: 3-year follow-up. Br J Ophthalmol. 2015 Dec 16.

-Wang W, Zhang X. Meta-analysis of randomized controlled trials comparing EX-PRESS implantation with trabeculectomy for open-angle glaucoma. PLoS One. 2014 Jun 27;9

Última modificación de la web: 11 September 2017