Long-term comparison using Ex-PRESS glaucoma shunt in black and white patients.
OBJECTIVE
To compare clinical outcomes, including patterns of failure, using the Ex-PRESS glaucoma shunt, in black and white patients with open-angle glaucoma.


METHODS
Retrospective comparative study.


METHODS
Sixty-three eyes of 50 black patients and 44 eyes of 34 white patients with open-angle glaucoma.


METHODS
The Ex-PRESS shunt procedure was performed for uncontrolled glaucoma in a series of white and black patients with glaucoma. Success was defined as an intraocular pressure (IOP) between 5 and 18 mm Hg, 20% reduction from baseline, with or without suture lysis or adjuvant medication, but no additional glaucoma surgery.


RESULTS
Mean length of follow-up was 29 months (range 12-81 months) for black patients and 25 months (range 12-66 months) for white patients. Mean preoperative IOP was 27 ± 7.2 and 30 ± 7.7 mm Hg for black and white patients, respectively. Mean postoperative IOP was 13 ± 3.6 and 12 ± 3.3 mm Hg for black and white patients, respectively. Using Kaplan-Meier survival curves, the success rates were 77.6% and 95% at 12 months for black and white patients, respectively. The log-rank test for comparison of survival curves indicated a significant difference between the 2 groups at 12 months (p = 0 .015) but revealed no difference at 2 years (p = 0.462).


CONCLUSIONS
This study shows that patterns of failure between black and white patients treated with the Ex-PRESS glaucoma shunt change significantly with the passage of time. Black patients experience failure early, whereas white patients experience failure later at a greater pace resulting in a similar survival rate at 2 years.
Department of Ophthalmology, State University of New York, Downstate Medical Center, Brooklyn, N.Y.. Electronic address: jfreedman50@hotmail.com.
Jeffrey
J
Freedman
Department of Ophthalmology, State University of New York, Downstate Medical Center, Brooklyn, N.Y.
Sara
S
Ferri
D001741:Black or African American / Q000208:ethnology*; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D020327:Glaucoma Drainage Implants; D005902:Glaucoma, Open-Angle / Q000208:ethnology / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D008297:Male; D019919:Prosthesis Implantation; D012189:Retrospective Studies; D014065:Tonometry, Ocular; D017211:Treatment Failure; D016896:Treatment Outcome; D014481:United States; D014792:Visual Acuity / Q000502:physiology; D044465:White People / Q000208:ethnology*