Assessment of Bleb Morphologic Features and Postoperative Outcomes After Ex-PRESS Drainage Device Implantation Versus Trabeculectomy
Purpose To investigate bleb morphologic features and postoperative outcomes after Ex-PRESS drainage device (Alcon Laboratories) implantation versus trabeculectomy. Design Retrospective, consecutive case-control series. Methods Information was collected from the charts of 35 consecutive Ex-PRESS proc...
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| Veröffentlicht in: | American journal of ophthalmology 2011-03, Vol.151 (3), p.507-513.e1 |
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| creator | Good, Travis J Kahook, Malik Y |
| description | Purpose To investigate bleb morphologic features and postoperative outcomes after Ex-PRESS drainage device (Alcon Laboratories) implantation versus trabeculectomy. Design Retrospective, consecutive case-control series. Methods Information was collected from the charts of 35 consecutive Ex-PRESS procedures and 35 consecutive trabeculectomy procedures with at least 2 years of follow-up. Intraocular pressure (IOP), bleb morphologic features, reduction of dependence on medication, visual recovery, number of postoperative visits, and postoperative complication rates were compared between groups. Results Average follow-up was 28 months (standard deviation, 3.23 months). Mean IOP measurements were similar after 6 months, then became slightly higher in the Ex-PRESS group at 1 year and at the final follow-up ( P = .004 and P = .008, respectively). Final percent IOP lowering was similar between groups ( P = .209). Unqualified success was achieved in 77.14% of Ex-PRESS and 74.29% of trabeculectomy procedures at last follow-up ( P = 1.00). An additional 5.71% and 8.57% reached qualified success for Ex-PRESS and trabeculectomy surgeries, respectively ( P = .99). Evaluation by the Moorfields Bleb Grading System revealed less vascularity and height but more diffuse area associated with the Ex-PRESS blebs, although these differences were absent at study completion. There were fewer cases of early postoperative hypotony and hyphema and quicker visual recovery in the Ex-PRESS group. The Ex-PRESS group required fewer postoperative visits compared with the trabeculectomy group ( P < .000). Conclusions Success of Ex-PRESS surgery, as defined in our study, was similar to trabeculectomy. Final IOP measurements were slightly lower after trabeculectomy compared with Ex-PRESS. Differences in some postoperative outcomes faded with follow-up. There remains a need for long-term prospective studies comparing these 2 procedures. |
| doi_str_mv | 10.1016/j.ajo.2010.09.004 |
| format | Article |
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Design Retrospective, consecutive case-control series. Methods Information was collected from the charts of 35 consecutive Ex-PRESS procedures and 35 consecutive trabeculectomy procedures with at least 2 years of follow-up. Intraocular pressure (IOP), bleb morphologic features, reduction of dependence on medication, visual recovery, number of postoperative visits, and postoperative complication rates were compared between groups. Results Average follow-up was 28 months (standard deviation, 3.23 months). Mean IOP measurements were similar after 6 months, then became slightly higher in the Ex-PRESS group at 1 year and at the final follow-up ( P = .004 and P = .008, respectively). Final percent IOP lowering was similar between groups ( P = .209). Unqualified success was achieved in 77.14% of Ex-PRESS and 74.29% of trabeculectomy procedures at last follow-up ( P = 1.00). An additional 5.71% and 8.57% reached qualified success for Ex-PRESS and trabeculectomy surgeries, respectively ( P = .99). Evaluation by the Moorfields Bleb Grading System revealed less vascularity and height but more diffuse area associated with the Ex-PRESS blebs, although these differences were absent at study completion. There were fewer cases of early postoperative hypotony and hyphema and quicker visual recovery in the Ex-PRESS group. The Ex-PRESS group required fewer postoperative visits compared with the trabeculectomy group ( P < .000). Conclusions Success of Ex-PRESS surgery, as defined in our study, was similar to trabeculectomy. Final IOP measurements were slightly lower after trabeculectomy compared with Ex-PRESS. Differences in some postoperative outcomes faded with follow-up. There remains a need for long-term prospective studies comparing these 2 procedures.</description><identifier>ISSN: 0002-9394</identifier><identifier>EISSN: 1879-1891</identifier><identifier>DOI: 10.1016/j.ajo.2010.09.004</identifier><identifier>PMID: 21236403</identifier><identifier>CODEN: AJOPAA</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Aged ; Antihypertensive Agents - administration & dosage ; Biological and medical sciences ; Case-Control Studies ; Conjunctiva - pathology ; Female ; Follow-Up Studies ; Glaucoma ; Glaucoma - physiopathology ; Glaucoma - surgery ; Glaucoma Drainage Implants ; Humans ; Intraocular Pressure - physiology ; Male ; Medical sciences ; Miscellaneous ; Ophthalmology ; Postoperative Complications ; Postoperative period ; Prosthesis Implantation ; Retrospective Studies ; Review boards ; Success ; Surgery ; Surgically-Created Structures - pathology ; Therapy ; Trabeculectomy ; Treatment Outcome ; Visual Acuity - physiology</subject><ispartof>American journal of ophthalmology, 2011-03, Vol.151 (3), p.507-513.e1</ispartof><rights>Elsevier Inc.</rights><rights>2011 Elsevier Inc.</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2011 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c531t-613e49039ede4249dfeb15755b2c1593821650b0c8b256768bfc89f5ff02ca643</citedby><cites>FETCH-LOGICAL-c531t-613e49039ede4249dfeb15755b2c1593821650b0c8b256768bfc89f5ff02ca643</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0002939410006793$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65534</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=23889916$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21236403$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Good, Travis J</creatorcontrib><creatorcontrib>Kahook, Malik Y</creatorcontrib><title>Assessment of Bleb Morphologic Features and Postoperative Outcomes After Ex-PRESS Drainage Device Implantation Versus Trabeculectomy</title><title>American journal of ophthalmology</title><addtitle>Am J Ophthalmol</addtitle><description>Purpose To investigate bleb morphologic features and postoperative outcomes after Ex-PRESS drainage device (Alcon Laboratories) implantation versus trabeculectomy. Design Retrospective, consecutive case-control series. Methods Information was collected from the charts of 35 consecutive Ex-PRESS procedures and 35 consecutive trabeculectomy procedures with at least 2 years of follow-up. Intraocular pressure (IOP), bleb morphologic features, reduction of dependence on medication, visual recovery, number of postoperative visits, and postoperative complication rates were compared between groups. Results Average follow-up was 28 months (standard deviation, 3.23 months). Mean IOP measurements were similar after 6 months, then became slightly higher in the Ex-PRESS group at 1 year and at the final follow-up ( P = .004 and P = .008, respectively). Final percent IOP lowering was similar between groups ( P = .209). Unqualified success was achieved in 77.14% of Ex-PRESS and 74.29% of trabeculectomy procedures at last follow-up ( P = 1.00). An additional 5.71% and 8.57% reached qualified success for Ex-PRESS and trabeculectomy surgeries, respectively ( P = .99). Evaluation by the Moorfields Bleb Grading System revealed less vascularity and height but more diffuse area associated with the Ex-PRESS blebs, although these differences were absent at study completion. There were fewer cases of early postoperative hypotony and hyphema and quicker visual recovery in the Ex-PRESS group. The Ex-PRESS group required fewer postoperative visits compared with the trabeculectomy group ( P < .000). Conclusions Success of Ex-PRESS surgery, as defined in our study, was similar to trabeculectomy. Final IOP measurements were slightly lower after trabeculectomy compared with Ex-PRESS. Differences in some postoperative outcomes faded with follow-up. There remains a need for long-term prospective studies comparing these 2 procedures.</description><subject>Aged</subject><subject>Antihypertensive Agents - administration & dosage</subject><subject>Biological and medical sciences</subject><subject>Case-Control Studies</subject><subject>Conjunctiva - pathology</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Glaucoma</subject><subject>Glaucoma - physiopathology</subject><subject>Glaucoma - surgery</subject><subject>Glaucoma Drainage Implants</subject><subject>Humans</subject><subject>Intraocular Pressure - physiology</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Miscellaneous</subject><subject>Ophthalmology</subject><subject>Postoperative Complications</subject><subject>Postoperative period</subject><subject>Prosthesis Implantation</subject><subject>Retrospective Studies</subject><subject>Review boards</subject><subject>Success</subject><subject>Surgery</subject><subject>Surgically-Created Structures - pathology</subject><subject>Therapy</subject><subject>Trabeculectomy</subject><subject>Treatment Outcome</subject><subject>Visual Acuity - physiology</subject><issn>0002-9394</issn><issn>1879-1891</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kk1v1DAQhiMEotvCD-CCLCHUUxZ_xEksJKSl3UKlolZs4Wo5zqR4SeLgSVbsnR-Ol12o1AMna-Tnna93kuQFo3NGWf5mPTdrP-c0xlTNKc0eJTNWFiplpWKPkxmllKdKqOwoOUZcxzAvsuJpcsQZF3lGxSz5tUAExA76kfiGvG-hIp98GL751t85Sy7AjFMAJKavyY3H0Q8QzOg2QK6n0foufi2aEQJZ_kxvPi9XK3IejOvNHZBz2DgL5LIbWtOPUeR78hUCTkhug6nATi3Y0XfbZ8mTxrQIzw_vSfLlYnl79jG9uv5weba4Sq0UbExzJiBTVCioIeOZqhuomCykrLhlUomSs1zSitqy4jIv8rJqbKka2TSUW5Nn4iQ53ecdgv8xAY66c2ihje2Bn1CXUnDOC8ki-eoBufZT6GNzmlGRy6LMRB4ptqds8IgBGj0E15mwjZDeOaTXOjqkdw5pqnR0KGpeHjJPVQf1P8VfSyLw-gAYtKZtgumtw3tOlKVSbFf87Z6DuLGNg6DROugt1C7Eterau_-28e6B2raud7Hgd9gC3k-rkWuqV7tT2l0S-3NESojf5u3C2A</recordid><startdate>20110301</startdate><enddate>20110301</enddate><creator>Good, Travis J</creator><creator>Kahook, Malik Y</creator><general>Elsevier Inc</general><general>Elsevier</general><general>Elsevier Limited</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>20110301</creationdate><title>Assessment of Bleb Morphologic Features and Postoperative Outcomes After Ex-PRESS Drainage Device Implantation Versus Trabeculectomy</title><author>Good, Travis J ; Kahook, Malik Y</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c531t-613e49039ede4249dfeb15755b2c1593821650b0c8b256768bfc89f5ff02ca643</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Aged</topic><topic>Antihypertensive Agents - administration & dosage</topic><topic>Biological and medical sciences</topic><topic>Case-Control Studies</topic><topic>Conjunctiva - pathology</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Glaucoma</topic><topic>Glaucoma - physiopathology</topic><topic>Glaucoma - surgery</topic><topic>Glaucoma Drainage Implants</topic><topic>Humans</topic><topic>Intraocular Pressure - physiology</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Miscellaneous</topic><topic>Ophthalmology</topic><topic>Postoperative Complications</topic><topic>Postoperative period</topic><topic>Prosthesis Implantation</topic><topic>Retrospective Studies</topic><topic>Review boards</topic><topic>Success</topic><topic>Surgery</topic><topic>Surgically-Created Structures - pathology</topic><topic>Therapy</topic><topic>Trabeculectomy</topic><topic>Treatment Outcome</topic><topic>Visual Acuity - physiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Good, Travis J</creatorcontrib><creatorcontrib>Kahook, Malik Y</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>American journal of ophthalmology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Good, Travis J</au><au>Kahook, Malik Y</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Assessment of Bleb Morphologic Features and Postoperative Outcomes After Ex-PRESS Drainage Device Implantation Versus Trabeculectomy</atitle><jtitle>American journal of ophthalmology</jtitle><addtitle>Am J Ophthalmol</addtitle><date>2011-03-01</date><risdate>2011</risdate><volume>151</volume><issue>3</issue><spage>507</spage><epage>513.e1</epage><pages>507-513.e1</pages><issn>0002-9394</issn><eissn>1879-1891</eissn><coden>AJOPAA</coden><abstract>Purpose To investigate bleb morphologic features and postoperative outcomes after Ex-PRESS drainage device (Alcon Laboratories) implantation versus trabeculectomy. Design Retrospective, consecutive case-control series. Methods Information was collected from the charts of 35 consecutive Ex-PRESS procedures and 35 consecutive trabeculectomy procedures with at least 2 years of follow-up. Intraocular pressure (IOP), bleb morphologic features, reduction of dependence on medication, visual recovery, number of postoperative visits, and postoperative complication rates were compared between groups. Results Average follow-up was 28 months (standard deviation, 3.23 months). Mean IOP measurements were similar after 6 months, then became slightly higher in the Ex-PRESS group at 1 year and at the final follow-up ( P = .004 and P = .008, respectively). Final percent IOP lowering was similar between groups ( P = .209). Unqualified success was achieved in 77.14% of Ex-PRESS and 74.29% of trabeculectomy procedures at last follow-up ( P = 1.00). An additional 5.71% and 8.57% reached qualified success for Ex-PRESS and trabeculectomy surgeries, respectively ( P = .99). Evaluation by the Moorfields Bleb Grading System revealed less vascularity and height but more diffuse area associated with the Ex-PRESS blebs, although these differences were absent at study completion. There were fewer cases of early postoperative hypotony and hyphema and quicker visual recovery in the Ex-PRESS group. The Ex-PRESS group required fewer postoperative visits compared with the trabeculectomy group ( P < .000). Conclusions Success of Ex-PRESS surgery, as defined in our study, was similar to trabeculectomy. Final IOP measurements were slightly lower after trabeculectomy compared with Ex-PRESS. Differences in some postoperative outcomes faded with follow-up. There remains a need for long-term prospective studies comparing these 2 procedures.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>21236403</pmid><doi>10.1016/j.ajo.2010.09.004</doi><tpages>7</tpages></addata></record> |
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| subjects | Aged Antihypertensive Agents - administration & dosage Biological and medical sciences Case-Control Studies Conjunctiva - pathology Female Follow-Up Studies Glaucoma Glaucoma - physiopathology Glaucoma - surgery Glaucoma Drainage Implants Humans Intraocular Pressure - physiology Male Medical sciences Miscellaneous Ophthalmology Postoperative Complications Postoperative period Prosthesis Implantation Retrospective Studies Review boards Success Surgery Surgically-Created Structures - pathology Therapy Trabeculectomy Treatment Outcome Visual Acuity - physiology |
| title | Assessment of Bleb Morphologic Features and Postoperative Outcomes After Ex-PRESS Drainage Device Implantation Versus Trabeculectomy |
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