Abstract:AIM:To evaluate the safety and efficacy of Ex-press implantation in primary open angle glaucoma(POAG)patients.
METHODS: This was a retrospective study of 37 eyes in 28 POAG patients who were treated with Ex-press implantation in Changsha Aier Hospital from August 2013 to July 2015. All subjects had a minimum 6-month follow-up(mean 15.0±5.5mo). Success was defined as intraocular pressure(IOP)was 6-21mmHg without complications, with or without glaucoma medicines. Life-table analysis was used to assess the cumulative probabilities of success in different follow-up time. Cox regression analysis was performed to estimate the relations between survival outcomes and multiple predictors.
RESULTS: The follow-up ranged from 6-24mo(mean 15.0±5.5mo). Visual acuity was significantly different between preoperation and the final follow-up(z=-2.40, P=0.016). The preoperative IOP was 37.4±12.7mmHg, and the postoperative IOP at 1d, 1wk, 1, 3, 6mo, 1, 1.5, 2a were 11.9±7.0, 9.4±3.9, 12.2±9.2, 11.5±6.4, 10.9±3.6, 11.5±5.8, 10.7±2.9 and 9.6±2.3mmHg, respectively. IOP was significantly different between preoperation and the final follow-up(F=24.45, P<0.05). The number of anti-glaucoma medications was significantly reduced from 2.24±1.21 at preoperation to 0.05±0.23 postoperative(Z=-2.02,P<0.05). The cumulative probabilities of success at 1d, 1wk, 1, 3, 6mo, 1, 1.5, 2a were 86.5%, 78.4%, 64.9%, 62.2%, 59.5%, 56.8%, 56.8% and 56.8%. The number of anti-glaucoma medications was identified as a risk factor for surgical failure by the Cox hazard model(P=0.02).
CONCLUSION: Ex-press implantation is effective and relatively safe for controlling the IOP in the POAG eyes. The procedure is simple and has fewer postoperative complications.