gms | German Medical Science

Purpose: The purpose of this study is to evaluate the results, with a one-year follow-up, of external filtration surgery by implantation of Ex-Press mini shunt device (Alcon/Novartis laboratories) in 40 eyes with open-angle glaucoma.

Methods: A prospective study of 40 eyes with long-term open-angle glaucoma was performed from 2013 to 2015 in two hospitals of Madrid (Hospital Universitario Infanta Sofía and Hospital Central de la Cruz Roja) for this study. All patients had filtration surgery (Ex-Press Implant model P-50 with the same surgical technique and without phacoemulsification) stopping topical medication. All patients were evaluated during one year.

Results: All patients completed the study and had a significant reduction in intraocular pressure (IOP) after the filtration surgery. Mean IOP before surgery was 24.2±5.18 mmHg decreasing to 17.4±3.3 at the end of the study. There was no statistically significant difference in the mean values of visual acuity after surgery (not associated to phacoemulsification). Flat anterior chamber related to hypotony during the early postoperative period appeared in 32.5% of cases but was solved spontaneously excepting in 3 cases where an AC reformation with viscolastic was necessary. Seven patients had choroidal effusion, without hypotonous maculopathy. Three patients had early bleb leak resolved with contact lenses.

Conclusions: Ex-Press filtration surgery allowed stopping topical treatment by decreasing IOP in all patients. It had no effect on postoperative values of visual acuity and had minimal complications in these patients.