AIM:To observe the clinical effect of Ex-PRESS glaucoma drainage device with adjustable suture for primary open angle glaucoma.

METHODS:The clinical data of 23 patients(including 29 eyes)from January 2013 to May 2015 who were diagnosed as primary open angle glaucoma were analyzed retrospectively. These patients who were 23～42 years old with the best corrected visual acuity(BCVA)from 50cm/finger count to 0.5 and the intraocular pressure(IOP)16～52mmHg did not respond well after using IOP-lowering drugs. After being treated with Ex-PRESS glaucoma drainage device associated with adjustable suture, the BCVA,IOP and the formation of filtering blebs were observed, while ultrasound biomicroscope(UBM )was used to observe whether the Ex-PRESS drainage device filterable passage was open or not.

RESULTS:The mean BCVA was 0.06～0.5 postoperatively; the mean IOP was 10±3mmHg at 1wk after treatments, which decreased significantly compared to that before treatments(P<0.05). Postoperative complications included 1 eye with shallow anterior chamber and 1 eye with anterior chamber hyphema on the second day after operation. The formation of filtering blebs in all the patients(29 eyes)were achieved successfully after disconnecting dermal sutures within 1wk postoperatively, except 1 eye of which filtering bleb was muffled at 3mo postoperatively. After examined by UBM, it was found that there was high density and hyper echoic obstruction,but no visible sclerotic filterable passage. The filterable passages in other 28 eyes were unobstructed by UBM examination.

CONCLUSION: Ex-PRESS glaucoma drainage device with adjustable suture for primary open-angle glaucoma is considered safe and effective. It is obvious that this clinical therapeutic technique is an ideal method with a low incidence of intraoperative risk and postoperative complications.