title: Comparison of trabeculectomy versus Ex-PRESS: 3-year follow-up.
abstract: OBJECTIVE
  To compare the outcomes of Ex-PRESS versus trabeculectomy at 3 years.
  
  
  METHODS
  Consenting patients aged 18-85 years with medically uncontrolled open-angle glaucoma scheduled for trabeculectomy were included in this study. 63 subjects were randomised to undergo Ex-PRESS (32) or trabeculectomy (31). Follow-up data included intraocular pressure (IOP), glaucoma medications, visual acuity (VA), complications and additional interventions. Complete success was defined as IOP between 5 and 18 mm Hg and 20% reduction from baseline without glaucoma medications, while qualified success was with or without glaucoma medications.
  
  
  RESULTS
  Complete success at 2 and 3 years was 43% vs 42% (p=0.78) and 35% vs 38% (p=0.92) in Ex-PRESS versus trabeculectomy, respectively. Qualified success at 2 and 3 years was 59% vs 76% (p=0.20) and 52% vs 61% (p=0.43) in Ex-PRESS versus trabeculectomy, respectively. Mean IOP at 2 and 3 years was 12.5±5.1 mm Hg vs 10.3±3.7 mm Hg (p=0.07) and 13.3±4.5 mm Hg vs 11.1±4.4 mm Hg (p=0.10) for Ex-PRESS versus trabeculectomy, respectively. At 3 years, 47.6% of Ex-PRESS and 50% of trabeculectomy patients were on glaucoma medications (p=1.00). No difference in VA was found after 3 years (logarithm of minimum angle of resolution 0.43±0.4 vs 0.72±0.8 for Ex-PRESS vs trabeculectomy, p=0.11). When excluding patients who underwent reoperation VA was better in the Ex-PRESS group at 1, 2 and 3 years. There were no complications after the first year in either group.
  
  
  CONCLUSIONS
  We found no difference in success rates, mean IOP or other secondary outcomes between Ex-PRESS and trabeculectomy after 3 years of follow-up.
  
  
  BACKGROUND
  NCT01263561; post results.
authors.affiliation: Department of Ophthalmology and Vision Sciences, Toronto Western Hospital/University of Toronto, Toronto, Ontario, Canada.
authors.forename: Johanna M
authors.initials: JM
authors.lastname: Gonzalez-Rodriguez
authors.affiliation: Department of Ophthalmology and Vision Sciences, Toronto Western Hospital/University of Toronto, Toronto, Ontario, Canada.
authors.forename: Graham E
authors.initials: GE
authors.lastname: Trope
authors.affiliation: Department of Ophthalmology and Vision Sciences, Toronto Western Hospital/University of Toronto, Toronto, Ontario, Canada.
authors.forename: Lilach
authors.initials: L
authors.lastname: Drori-Wagschal
authors.affiliation: Department of Ophthalmology, Queen's University, Kingston, Ontario, Canada.
authors.forename: Delan
authors.initials: D
authors.lastname: Jinapriya
authors.affiliation: Department of Ophthalmology and Vision Sciences, Toronto Western Hospital/University of Toronto, Toronto, Ontario, Canada.
authors.forename: Yvonne M
authors.initials: YM
authors.lastname: Buys
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D020327:Glaucoma Drainage Implants; D005902:Glaucoma, Open-Angle / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013997:Time Factors; D014065:Tonometry, Ocular / Q000379:methods*; D014130:Trabeculectomy / Q000379:methods*; D016896:Treatment Outcome; D014792:Visual Acuity; D055815:Young Adult
keywords: Glaucoma; Intraocular pressure; Treatment Surgery