title: EX-PRESS glaucoma filtration device: Review of clinical experience and comparison with trabeculectomy.
abstract: Glaucoma filtration surgery is performed to reduce intraocular pressure (IOP) in patients for whom maximal tolerable pharmacologic IOP-lowering therapy and/or laser surgery fail to lower IOP sufficiently and/or fail to prevent optic nerve damage or visual field deterioration. For decades, the most widely utilized procedure for glaucoma filtration surgery has been trabeculectomy. Although this approach reliably provides long-term IOP reduction in many patients, the postoperative complication rate is high. This has driven the development of alternative approaches to reduce IOP surgically. The EX-PRESS glaucoma filtration device was developed to mimic IOP control by trabeculectomy and to have a better safety profile. This non-valved, medical-grade stainless steel device diverts aqueous humor from the anterior chamber to an intrascleral space. Despite the widespread use of the EX-PRESS device, only a few studies compare its efficacy and safety with that of trabeculectomy. We analyze available data regarding the safety and efficacy of the EX-PRESS device, particularly in comparison with trabeculectomy.
authors.affiliation: Glaucoma sector, University of Geneva, Geneva, Switzerland.
authors.forename: Tarek
authors.initials: T
authors.lastname: Shaarawy
authors.affiliation: Discipline of Ophthalmology, University of Sydney, Sydney, Australia.
authors.forename: Ivan
authors.initials: I
authors.lastname: Goldberg
authors.affiliation: Institute of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark, NJ, USA. Electronic address: fechtner@rutgers.edu.
authors.forename: Robert
authors.initials: R
authors.lastname: Fechtner
mesh_terms: D001082:Aqueous Humor / Q000502:physiology; D005901:Glaucoma / Q000503:physiopathology / Q000601:surgery*; D020327:Glaucoma Drainage Implants; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D019919:Prosthesis Implantation; D014130:Trabeculectomy
keywords: glaucoma; glaucoma filtration device; intraocular pressure; postoperative complications; trabeculectomy