title: Ex-PRESS miniature glaucoma device implanted under a scleral flap alone or combined with phacoemulsification cataract surgery.
abstract: OBJECTIVE
  Our purpose was to evaluate the clinical outcomes of the Ex-PRESS miniature glaucoma device placed under a partial-thickness scleral flap as a single procedure or combined with phacoemulsification cataract surgery.
  
  
  METHODS
  This was a comparative consecutive case series of 345 eyes: 231 eyes treated with Ex-PRESS implant under scleral flap alone and 114 eyes treated with Ex-PRESS implant under scleral flap combined with phacoemulsification (both groups were treated intraoperatively with mitomycin C).
  
  
  RESULTS
  The patients were followed for 25.7+/-11.1 (range, 1 to 46.2) months (Ex-PRESS alone) and 21.9+/-12.5 (range, 1.9 to 46.2) months (combined cases). At 3 years after surgery, surgical success was 94.8% and 95.6% in the Ex-PRESS and combined groups, respectively (P=0.948). Compared with baseline values, the postoperative intraocular pressure (IOP) and number of glaucoma medications were significantly lowered in both groups. The change from baseline IOP was significantly greater after Ex-PRESS implant alone compared with combined surgery (P<0.001). The most common device-related complication was obstruction of the tube (6 eyes), which was treated successfully with Nd:YAG laser in all 6 eyes.
  
  
  CONCLUSIONS
  The use of the Ex-PRESS implant under a scleral flap was effective for lowering IOP both alone and combined with cataract surgery. The most common device-related complication was tube blockage, which was treated with the Nd:YAG laser.
authors.affiliation: Department of Ophthalmology, Hamilton Eye Institute, University of Tennessee Health Science Center, Memphis, TN 38163, USA.
authors.forename: Elliott M
authors.initials: EM
authors.lastname: Kanner
authors.forename: Peter A
authors.initials: PA
authors.lastname: Netland
authors.forename: Steven R
authors.initials: SR
authors.lastname: Sarkisian
authors.forename: Haiming
authors.initials: H
authors.lastname: Du
mesh_terms: D000368:Aged; D002386:Cataract / Q000150:complications / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D005901:Glaucoma / Q000150:complications / Q000601:surgery; D020327:Glaucoma Drainage Implants; D006801:Humans; D007429:Intraocular Pressure; D007431:Intraoperative Complications; D019654:Lens Implantation, Intraocular; D008297:Male; D008875:Middle Aged; D008904:Miniaturization; D018918:Phacoemulsification; D011183:Postoperative Complications; D019919:Prosthesis Implantation / Q000379:methods; D012189:Retrospective Studies; D012590:Sclera / Q000601:surgery*; D013524:Surgical Flaps; D016896:Treatment Outcome