Long-term efficacy and safety of Ex Press implantation for treatment of open angle glaucoma

AIM: To compare the long-term efficacy and safety of Ex Press implantation and standard trabeculectomy in patients with primary open angle glaucoma(POAG).METHODS: In this retrospective study, we compared 17 eyes treated by Ex Press implantation with 23 eyes treated by trabeculectomy. Efficacy was assessed according to the relevant intraocular pressure(IOP) values and success rates during the first year of follow-up. Postoperative corneal endothelial cell loss was also compared. RESULTS: The number of antiglaucoma medications and the IOP reduction were similar between the 2 groups during the follow-up period. Although the mean IOP was similar, the IOP-fluctuation rate during the early postoperative period was significantly lower in the Ex Press group than in the trabeculectomy group(P=0.038). A Kaplan-Meier survival curve analysis showed no significant successrate difference between the groups(P=0.810). The corneal endothelial cell loss rate, moreover, was significantly lower in the Ex Press group(P=0.05). CONCLUSION: Ex Press implantation compared with trabeculectomy showed similar IOP-reduction and success rates along with lower IOP fluctuation and endothelial cell loss rates. For this reason, it can be considered to be the treatment of choice for patients with advanced glaucoma or low corneal endothelial cell density.