Technique for Intraoperative Reuse of Ex-PRESS Delivery System

PURPOSE:To report a new technique for reloading the Ex-PRESS glaucoma filtration device on the Ex-PRESS delivery system (Alcon Laboratories) for revised placement of an implant. PATIENT AND METHODS:The Ex-PRESS is provided on a single-use delivery system. A patient who underwent Ex-PRESS placement was noted intraoperatively to have had an unsatisfactory implant position upon initial insertion. The used inserter metallic rod was manipulated to resume its original shape. The implant was removed and reloaded onto the delivery system, which was then used to place it in the desired position. RESULTS:Intraoperative delivery system reloading is possible and facilitates repositioning of the Ex-PRESS implant. CONCLUSIONS:This technique for reloading the Ex-PRESS will allow the surgeon to make adjustments to an unsatisfactorily positioned implant upon initial insertion. This may help optimize implant positioning, minimize insertion malpositioning, and reduce the cost and time of using more than 1 device.