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Risk factors for Ex-Press® surgery failure

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Abstract

Purpose

To investigate the risk factors for Ex-Press® (EXP) surgery failure.

Patients and methods

This was a retrospective non-randomized study of 98 patients who had undergone EXP and were followed up ≥ 5 years. We investigated the following nine risk factors: age, gender, hypertension, diabetes mellitus (DM), previous glaucoma surgery, type of glaucoma (primary open-angle glaucoma vs. pseudo-exfoliation glaucoma), surgical methods (EXP alone vs. EXP + cataract surgery simultaneously), central corneal thickness (CCT), and preoperative intraocular pressure (IOP). We defined a successful surgery as a postoperative reduction in the IOP ≥ 20% from the preoperative IOP and ≤ 18 mmHg. We determined the risk factors using multivariate cox regression models.

Results

Performing EXP significantly decreased the IOP (preoperative: 25.2 ± 8.7, at 5 years: 11.1 ± 4.1). The success ratio of EXP was 67.4% at 5 years. We found no significant risk factors for EXP surgery failure. The p values of the factors were age (p = 0.936), gender (p = 0.0587), hypertension (p = 0.409), DM (p = 0.967), previous glaucoma surgery (p = 0.940), type of glaucoma (p = 0.435) surgical methods (p = 0.521), CCT (p = 0.091), and preoperative IOP (p = 0.082).

Conclusions

No preoperative factors that could be used to predict the failure of EXP surgery were identified. EXP can be safely performed for primary open-angle glaucoma and pseudo-exfoliation glaucoma.

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Funding

The authors declare that no funds, grants, or other support was received during the preparation of this manuscript. The authors have no relevant financial or non-financial interests to disclose.

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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

    Mitsuya Otsuka, Naoki Tojo & Atsushi Hayashi

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

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Correspondence to Naoki Tojo.

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Competing interests

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

Ethical approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Toyama University.

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

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Cite this article

Otsuka, M., Tojo, N. & Hayashi, A. Risk factors for Ex-Press® surgery failure. Int Ophthalmol 43, 1657–1663 (2023). https://doi.org/10.1007/s10792-022-02554-5

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