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Ex-PRESS® surgery versus trabeculectomy for primary open-angle glaucoma with low preoperative intraocular pressure

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Abstract

Purpose

To compare surgical outcomes between Ex-PRESS® surgery (EXP) and trabeculectomy (Trab) for primary open-angle glaucoma (POAG) with low preoperative intraocular pressure (IOP).

Patients and methods

This was a retrospective non-randomized study. We included POAG patients with preoperative IOP ≤ 16 mmHg who were taking tolerance glaucoma medications. We compared the surgical outcomes, postoperative IOP, number of glaucoma medications, reduction rate of corneal endothelial cell density (ECD), visual acuity, and postoperative complications between POAG patients who underwent EXP (34 eyes) or Trab (38 eyes) and could be followed up for > 2 years.

Results

Both surgeries significantly decreased the IOP (p < 0.001): At 2 years, EXP provided decreases from 13.4 ± 2.3 to 10.2 ± 3.1 mmHg, and Trab provided decreases from 13.5 ± 2.0 to 8.9 ± 3.2 mmHg. No significant differences were observed in the postoperative IOP (p = 0.076), number of postoperative medications (p = 0.263), success rate (p = 0.900), reduction rate of ECD (p = 0.410), or difference in visual acuity (p = 0.174). The reduction rate of IOP was significantly high in the Trab group (p = 0.047).

Conclusions

Both surgeries significantly decreased IOP and were useful surgical methods for low-IOP glaucoma. Our results suggest that trabeculectomy can decrease IOP more than Ex-PRESS surgery but might have more complications.

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Funding

No funding was received for this research.

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Authors and Affiliations

  1. Department of Ophthalmology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan

    Mitsuya Otsuka, Atsushi Hayashi & Naoki Tojo

Authors
  1. Mitsuya Otsuka
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  2. Atsushi Hayashi
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  3. Naoki Tojo
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by MO and NT. The first draft of the manuscript was written by MO and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Naoki Tojo.

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Conflict of interest

The authors have no relevant financial or non-financial interests to disclose.

Ethical approval

All procedures were performed in accord with the ethical standards of the Institutional Review Board of the University of Toyama (Toyama, Japan) and the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Formal patient consent was not required for the present retrospective analysis.

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Informed consent was obtained from all individual participants included in the study.

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Otsuka, M., Hayashi, A. & Tojo, N. Ex-PRESS® surgery versus trabeculectomy for primary open-angle glaucoma with low preoperative intraocular pressure. Int Ophthalmol 42, 3367–3375 (2022). https://doi.org/10.1007/s10792-022-02335-0

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