Ex-PRESS implantation with phacoemulsification in POAG versus CPACG.
OBJECTIVE
To compare the long-term outcomes of the Ex-PRESS miniature glaucoma device implanted under a scleral flap in combination of phacoemulsification with intraocular lens implantation in primary open angle glaucoma (POAG) and chronic primary angle-closure glaucoma (CPACG).


METHODS
Retrospective, comparative study. A total of 60 eyes (60 patients) receiving the Ex-PRESS miniature glaucoma device implantation combined with phacoemulsification were reviewed. Thirty eyes (30 patients) had the combined procedures for POAG, and the other 30 eyes (30 patients) for CPACG.


RESULTS
The follow-up was 39.37±7.09mo (range 3 to 49mo) in patients with POAG and 37.10±9.26mo (range 9 to 49mo) in patients with CPACG (P=0.29). The mean change in best corrected visual acuity was 0.41 logMAR for POAG and 0.38 logMAR for CPACG at the last follow-up (P=0.22). The postoperative intraocular pressure (IOP) of the POAG group was significantly lower than the CPACG group at 1, 3, 12, and 18mo after surgery (P=0.02, 0.00, 0.04, 0.01) with similar glaucoma medications after surgery (P>0.16). At 3y after surgery, the cumulative complete and qualified success rates were 63.3% (POAG) and 53.3% (CPACG), 83.3% (POAG) and 73.3% (CPACG) (P=0.41, 0.49), respectively. The POAG group had more hypotony than the CPACG group (P=0.04).


CONCLUSIONS
The long-term outcomes show the Ex-PRESS implantation combined with phacoemulcification can effectively lower the IOP in both the POAG and CPACG groups. The POAG group seems to have lower postoperative IOP and a higher risk of hypotony.
Qingdao University Medical College, Qingdao 266071, Shandong Province, China; Qingdao Eye Hospital, Shandong Eye Institute, Shandong Academy of Medical Sciences, Qingdao 266071, Shandong Province, China.
Jie
J
Lan
Qingdao Eye Hospital, Shandong Eye Institute, Shandong Academy of Medical Sciences, Qingdao 266071, Shandong Province, China.
Da-Peng
DP
Sun
Qingdao Eye Hospital, Shandong Eye Institute, Shandong Academy of Medical Sciences, Qingdao 266071, Shandong Province, China.
Jie
J
Wu
Qingdao Eye Hospital, Shandong Eye Institute, Shandong Academy of Medical Sciences, Qingdao 266071, Shandong Province, China.
Ya-Ni
YN
Wang
Qingdao Eye Hospital, Shandong Eye Institute, Shandong Academy of Medical Sciences, Qingdao 266071, Shandong Province, China.
Li-Xin
LX
Xie
Ex-PRESS miniature glaucoma device; cataract surgery; glaucoma; phacoemulsification