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Ex-Press® versus Baerveldt implant surgery for primary open-angle glaucoma and pseudo-exfoliation glaucoma

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Abstract

Purpose

To compare surgical outcomes between Ex-Press® (EXP) and Baerveldt glaucoma implant (BGI) surgeries for primary open-angle glaucoma (POAG) and pseudo-exfoliation glaucoma (PEXG) patients.

Patients and methods

This was a retrospective single-facility study. The inclusion criteria were that the patient's preoperative intraocular pressure (IOP) was > 21 mmHg and the post-surgery follow-up was > 1 year. We recruited 161 patients who had undergone a trabeculectomy with EXP (89 eyes) or BGI surgery (72 eyes). We compared these groups' postoperative IOP values and postoperative glaucoma medications, the reduction rate of corneal endothelial cell density (ECD), surgical outcomes, complications, the hospital stay duration, and the number of visits within 3 months post-surgery.

Results

Both the EXP and BGI surgeries could significantly decrease the IOP. When the surgical success was defined postoperative IOP ≤ 21 mmHg, the surgical outcome of BGI was significantly better than EXP (p = 0.0148). When the surgical success was defined postoperative IOP ≤ 18, 15 , and 12 mmHg, the surgical outcomes between BGI and EXP surgeries were not significantly different (p = 0.0815, p = 0.331, and p = 0.910). The mean ECD reduction rate was significantly faster in the EXP group. The BGI patients had significantly shorter stays in the hospital and fewer visits within 3 months post-surgery (p < 0.0001).

Conclusions

BGI surgery could provide comparable surgical outcomes as EXP surgery for POAG or PEXG patients with high preoperative IOP. BGI surgery has some advantages: fewer post-surgery visits, less postoperative interventions, and a lower ECD reduction rate.

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Availability of data and material

The datasets during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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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 City, 930-0194, Japan

    Naoki Tojo & Atsushi Hayashi

Authors
  1. Naoki Tojo
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  2. Atsushi Hayashi
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Contributions

NT took part in analysis and interpretation of data and drafting of the article. AH participated in final approval of the article.

Corresponding author

Correspondence to Naoki Tojo.

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Conflict of interest

The authors declare that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers' bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge, or beliefs) in the subject matter or materials discussed in this manuscript.

Ethics approval

All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Consent to participate

Each patient in this study provided informed consent after a thorough explanation of the study.

Consent for publication

We obtained consent for publication from each patient.

Code availability

We used JMP for statistical analysis.

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Tojo, N., Hayashi, A. Ex-Press® versus Baerveldt implant surgery for primary open-angle glaucoma and pseudo-exfoliation glaucoma. Int Ophthalmol 41, 1091–1101 (2021). https://doi.org/10.1007/s10792-020-01668-y

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  • DOI: https://doi.org/10.1007/s10792-020-01668-y

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