Ex-PRESS better than trabeculectomy

The Ex-PRESS implant appears to be as effective as trabeculectomy, furthermore it reduces postoperative compliance issues and seems to be safer, according to a paper presented at this year's World Glaucoma Congress held in Singapore.

In a prospective clinical study, 34 pseudophakic glaucomatous subjects, not controlled by topical therapy, were randomized into two groups to receive either the Ex-PRESS implant or undergo trabeculectomy. All subjects had a postoperative intraocular pressure (IOP) measurement over 24 mmHg.

In the Ex-PRESS group (17 subjects), preoperative IOP was 26±2.18 mmHg and in the trabeculectomy group (17 subjects) it was 26.7±1.98 mmHg. At one week follow-up the mean IOP had fallen to 14±4.2 mmHg (p=<0.001) and 15.4±3.6 mmHg (P=<0.001), in the Ex-PRESS and trabeculectomy group, respectively. In the Ex-PRESS group, two eyes required an anterior chamber (AC) viscoelastic refilling for AC flattening. In the trabeculectomy group, four eyes had choroidal detachment, three eyes had AC flattening requiring an AC refilling and two eyes had hyphema.

It was concluded that, not only is the Ex-PRESS as effective as trabeculectomy in lowering IOP, it is also safer.