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, Lorna (Beth) Edmunds, Nili Stein, David M. Steinberg, Orna Geyer

Research output: Contribution to journalArticle

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

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Surgical Instruments
Glaucoma
Phacoemulsification
Reoperation
Trabeculectomy
Therapeutics
Outcome Assessment (Health Care)

Keywords

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

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Ex-PRESS Miniature Glaucoma Shunt versus Ahmed Glaucoma Valve in the Surgical Treatment of Glaucoma in Pseudophakic Patients. / Rabkin-Mainer, Zoya; Wolf, Alvit; Mathalone, Nurit; Malamud, Alina; Buckman, Gila; Edmunds, Lorna (Beth); Stein, Nili; Steinberg, David M.; Geyer, Orna.

In: Journal of Glaucoma, 01.01.2018.

Research output: Contribution to journalArticle

Rabkin-Mainer, Zoya ; Wolf, Alvit ; Mathalone, Nurit ; Malamud, Alina ; Buckman, Gila ; Edmunds, Lorna (Beth) ; Stein, Nili ; Steinberg, David M. ; Geyer, Orna. / Ex-PRESS Miniature Glaucoma Shunt versus Ahmed Glaucoma Valve in the Surgical Treatment of Glaucoma in Pseudophakic Patients. In: Journal of Glaucoma. 2018.
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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.",
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AU - Rabkin-Mainer, Zoya

AU - Wolf, Alvit

AU - Mathalone, Nurit

AU - Malamud, Alina

AU - Buckman, Gila

AU - Edmunds, Lorna (Beth)

AU - Stein, Nili

AU - Steinberg, David M.

AU - Geyer, Orna

PY - 2018/1/1

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N2 - 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.

AB - 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.

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KW - pseudophakia

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