Ex-PRESS Miniature Glaucoma Shunt versus Ahmed Glaucoma Valve in the Surgical Treatment of Glaucoma in Pseudophakic Patients

Zoya Rabkin-Mainer, Alvit Wolf, Nurit Mathalone, Alina Malamud, Gila Buckman, Beth Edmunds, Nili Stein, David M. Steinberg, Orna Geyer

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

Purpose: To compare the 3-year outcome of Ex-PRESS miniature glaucoma shunt versus Ahmed glaucoma valve in pseudophakic patients. Patients and Methods: We retrospectively reviewed the records of patients with a history of clear-corneal phacoemulsification alone, or failed trabeculectomy following phacoemulsification who subsequently underwent AGV implantation or Ex-PRESS shunt surgery. The main outcome measure, surgical success, was defined as an IOP between 5mmHg and 21 mm Hg and a 20% IOP reduction from baseline (with/ without glaucoma medications) without glaucoma reoperation. Results: Ninety two patients (92 eyes) were included (43 AGV, 49 Ex-PRESS). Overall success at 3 years was 92.7% for AGV and 66.1% for Ex-PRESS (P = 0.006). AGV had a higher success rate in patients with prior phacoemulsification and failed trabeculectomy (96% AGV vs. 64.1% Ex-PRESS, P= 0.023). There was no difference in success rate for patients with only previous phacoemulsification. (87.5% AGV vs. 69.4% Ex-PRESS, P = 0.205). Glaucoma reoperation rates were 4.6% and 30.6% in the AGV and Ex-PRESS group respectively (P=0.001). Both procedures had similar complication rates. Conclusions: AGV compared with Ex-PRESS shunt, had a higher success rate for secondary surgeries but not primary surgeries, in patients with prior clear-corneal phacoemulsification, The AGV surgery also had a lower overall glaucoma reoperation rate.

Original languageEnglish (US)
JournalJournal of Glaucoma
DOIs
StateAccepted/In press - Jan 1 2018
Externally publishedYes

Keywords

  • Ahmed glaucoma valve (AGV)
  • Ex-PRESS shunt
  • glaucoma
  • pseudophakia

ASJC Scopus subject areas

  • Ophthalmology

Fingerprint Dive into the research topics of 'Ex-PRESS Miniature Glaucoma Shunt versus Ahmed Glaucoma Valve in the Surgical Treatment of Glaucoma in Pseudophakic Patients'. Together they form a unique fingerprint.

  • Cite this

    Rabkin-Mainer, Z., Wolf, A., Mathalone, N., Malamud, A., Buckman, G., Edmunds, B., Stein, N., Steinberg, D. M., & Geyer, O. (Accepted/In press). Ex-PRESS Miniature Glaucoma Shunt versus Ahmed Glaucoma Valve in the Surgical Treatment of Glaucoma in Pseudophakic Patients. Journal of Glaucoma. https://doi.org/10.1097/IJG.0000000000001050