Ex-PRESS device exposure warning

With increasing numbers of patients undergoing filtration surgery with the Ex-PRESS Miniature Glaucoma devices (Optonol), anterior segment surgeons should be aware of the potential for device exposure, according to a case series reported in the December 2007 issue of the Journal of Glaucoma.

Joshua Stein and colleagues from Duke University, North Carolina, USA conducted a retrospective chart review to identify all patients who were referred for Ex-PRESS miniature glaucoma device exposure between January 2004 and December 2005.

A total of six patients (eight eyes) experienced device exposure, with an average time to exposure of 8.5 months. In two eyes, the shunt had been inserted under a half-thickness flap. In both these eyes and in one additional eye, Mitomycin-C had been used during shunt insertion. In five eyes, visual acuity worsened after the device was removed and all eight patients required concomitant glaucoma surgery with device removal.

The authors of this report suggest that anterior segment surgeons should be aware of the possibility of device exposure when using the Ex-PRESS.