Li Nie1, Aiwu Fang1, Weihua Pan1, Han Ye1, Yau Kei Chan2, Lin Fu1, Jia Qu1. 1. a The Eye Hospital, School of Ophthalmology and Optometry , Wenzhou Medical University , Wenzhou , China. 2. b Department of Mechanical Engineering , University of Hong Kong , Hong Kong , China.
Abstract
PURPOSE: To evaluate the feasibility, efficacy, and safety of Ex-PRESS implantation combined with phacoemulsification surgery in primary angle-closure glaucoma (PACG) with cataract. MATERIALS AND METHODS: This is a prospective, nonrandomized study. A total of 34 eyes of 34 subjects were enrolled. The assessments were conducted preoperatively and postoperatively at 1 week and 1, 3, 6, 12, 18, 24, 30, and 36 months. The assessments included intraocular pressure (IOP), best-corrected visual acuity (BCVA), the number of glaucoma medications, corneal endothelial cell density (ECD), and related complications, if any. The anterior segment structure was also assessed by anterior segment optical coherence tomography based on the anterior chamber depth (ACD), angle opening distance (AOD500), and trabecular-iris angle (TIA). A complete success was defined as a controlled IOP between 5 and 21 mmHg without medications. RESULTS: The complete success rates at 12, 24, and 36 postoperative months were 91.2%, 81.7%, and 78.3%, respectively. The mean preoperative IOP was 28.43 ± 12.93 mmHg and decreased to 15.35 ± 4.02 mmHg at 3 years postoperatively (P < 0.001). The number of medications decreased from 2.47 ± 1.89 at baseline to 0.28 ± 0.76 at 3 years postoperatively (P = 0.001). BCVA was 0.83 ± 0.58 at baseline and 0.51 ± 0.33 at 3 years postoperatively (P = 0.008). The ACD, AOD500, and TIA significantly increased at 3 months postoperatively compared with baseline (P < 0.001). ECD at 3 months and 3 years postoperatively were both significantly lower compared with baseline (P = 0.03), but was not significantly different between 3 months and 3 years postoperatively (P = 0.07). The device-related complications identified were hypotony (5.8%), hyphema (2.9%), and iris touch (2.9%), which the incidence rates were all very low. CONCLUSIONS: Ex-PRESS implantation combined with phacoemulsification was effective for lowering IOP in PACG coexisting with cataract. The device-related complication was rare.
PURPOSE: To evaluate the feasibility, efficacy, and safety of Ex-PRESS implantation combined with phacoemulsification surgery in primary angle-closure glaucoma (PACG) with cataract. MATERIALS AND METHODS: This is a prospective, nonrandomized study. A total of 34 eyes of 34 subjects were enrolled. The assessments were conducted preoperatively and postoperatively at 1 week and 1, 3, 6, 12, 18, 24, 30, and 36 months. The assessments included intraocular pressure (IOP), best-corrected visual acuity (BCVA), the number of glaucoma medications, corneal endothelial cell density (ECD), and related complications, if any. The anterior segment structure was also assessed by anterior segment optical coherence tomography based on the anterior chamber depth (ACD), angle opening distance (AOD500), and trabecular-iris angle (TIA). A complete success was defined as a controlled IOP between 5 and 21 mmHg without medications. RESULTS: The complete success rates at 12, 24, and 36 postoperative months were 91.2%, 81.7%, and 78.3%, respectively. The mean preoperative IOP was 28.43 ± 12.93 mmHg and decreased to 15.35 ± 4.02 mmHg at 3 years postoperatively (P < 0.001). The number of medications decreased from 2.47 ± 1.89 at baseline to 0.28 ± 0.76 at 3 years postoperatively (P = 0.001). BCVA was 0.83 ± 0.58 at baseline and 0.51 ± 0.33 at 3 years postoperatively (P = 0.008). The ACD, AOD500, and TIA significantly increased at 3 months postoperatively compared with baseline (P < 0.001). ECD at 3 months and 3 years postoperatively were both significantly lower compared with baseline (P = 0.03), but was not significantly different between 3 months and 3 years postoperatively (P = 0.07). The device-related complications identified were hypotony (5.8%), hyphema (2.9%), and iris touch (2.9%), which the incidence rates were all very low. CONCLUSIONS: Ex-PRESS implantation combined with phacoemulsification was effective for lowering IOP in PACG coexisting with cataract. The device-related complication was rare.