AIM: To observe the clinical efficacy and safety of the Ex-press miniature glaucoma device placed under scleral flap combined mitomycin C for the treatment of refractory glaucoma.

METHODS: This retrospective analysis comprised 18 eyes of 18 patients who suffered from refractory glaucoma and treated with Ex-press miniature glaucoma device implantation combined mitomycin C in January 2014 to May 2015 in Jingzhou Central Hospital. All patients were followed at least 12mo. The visual acuity, intraocular pressure(IOP), complications and filtering bleb were recorded and statistically analyzed preoperative and 1d, 1, 2wk, 1, 6 and 12mo after operation.

RESULTS: Average intraocular pressure was 43.83±7.99mmHg preoperative and decreased significantly at every time point postoperative(8.72±3.29, 11.56±1.86, 13.33±2.30, 13.67±2.03, 14.78±3.64, 16.61±7.19mmHg respectively), the difference was statistically significant(t=16.475, 15.324, 14.761, 14.172, 12.140, 11.412, P<0.05). The successful rate was 89% at 12mo after operation, and 3 eyes with improved vision, 12 eyes with unchanged vision, 3 eyes with decreased vision. Early complications were mainly anterior chamber bleeding and postoperative shallow anterior chamber, and late complications were non-functional bleb. There were no serious or unexpected complications in our group of patients.

CONCLUSION:The Ex-press miniature glaucoma device implantation combined mitomycin C in the treatment of refractory glaucoma is a safe and effective method, which has few surgical complications and less damage to eyesight, and make the stability control of postoperative intraocular pressure.