Purpose: Ex-PRESS shunt is an alternative filtration procedure to trabeculectomy. This study aimed to compare the 1-year cost differences between the 2 operations.
Methods: Subjects were enrolled in a randomized controlled trial comparing Ex-PRESS to trabeculectomy. Surgical cost difference and 1-year postoperative costs (follow-up visits, additional procedures, and medications) were determined and compared. The 95% confidence interval of incremental cost-effectiveness ratio was estimated using bootstrap method.
Results: Forty-three subjects with 1-year follow-up were included. Success rate was not significantly different for Ex-PRESS (65%) versus trabeculectomy (55%, P=0.49). Ex-PRESS had a net surgical cost of $956 greater than trabeculectomy. There was no significant difference in the overall postoperative cost [median (interquartile range); $485 (337, 822) vs. $609 (387, 820), P=0.78], cost of follow-up visits [$303 (275, 358) vs. $317 (275, 385), P=0.75], additional procedures [$182 (0, 365) vs. $182 (0, 365), P=0.69], or glaucoma medication [$0 (0, 68) vs. $0 (0, 90), P=0.8] for Ex-PRESS versus trabeculectomy, respectively. The overall 1-year cost was significantly greater for Ex-PRESS and the incremental cost-effectiveness ratio was $9625 (95% confidence interval, $2435-548,084).
Conclusions: Ex-PRESS is associated with greater surgical cost compared with trabeculectomy. This needs to be considered in conjunction with efficacy and safety if Ex-PRESS is to supersede trabeculectomy.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1097/IJG.0b013e31827a06f4 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Clinical outcomes of Xen 45 gel stent implantation(Ab externo, open conjunctival approach) versus Trabeculectomy: A real world study.
Korean J Ophthalmol
December 2024
Department of Ophthalmology, Institute of Vision Research, Severance Eye Hospital, Yonsei University College of Medicine, South Korea.
Article Synopsis
- The study compared clinical outcomes of Xen 45 gel stent surgery and trabeculectomy in glaucoma patients, analyzing data from 62 eyes treated with Xen and 78 eyes with trabeculectomy over specific periods.
- Results showed a lower complete success rate for Xen (33.9%) compared to trabeculectomy (57.7%), along with higher postoperative intraocular pressure and more glaucoma medications needed in the Xen group; however, it had fewer complications (0% vs. 16.7%) and shorter operation time.
- Both surgical methods yielded similar postoperative best corrected visual acuity but differed in success rates, medication requirements, and safety profiles, indicating that while Xen may be quicker and safer
Outcomes of Second Trabeculectomy Versus Glaucoma Drainage Device in Juvenile Open-angle Glaucoma After Primary Trabeculectomy Failure.
J Glaucoma
December 2024
Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA.
Precis: Second trabeculectomy and glaucoma drainage device implantation offer similar success rates for juvenile open angle glaucoma after initial trabeculectomy failure. However, second trabeculectomies required fewer medications. A quarter of patients in both groups required a third operation after 2.
View Article and Find Full Text PDFPreserflo MicroShunt Implantation: A Narrative Review of Its Standalone Benefits vs. Combined Use with Phacoemulsification in Managing Open-Angle Glaucoma.
Ophthalmol Ther
January 2025
Department of Ophthalmology, Medical University of Bialystok, M. Sklodowskiej-Curie 24 A STR, 15-276, Bialystok, Poland.
Glaucoma and cataract often coexist. Patients with both conditions who qualify for surgical treatment may undergo either a combined surgical procedure or sequential treatments such as cataract surgery followed by an antiglaucoma procedure. A combined procedure with phacoemulsification is related to an increased risk of fibrosis of the filtering bleb; however, it is a rational approach for patients with high intraocular pressure and clinically significant lens opacification.
View Article and Find Full Text PDFComparison of postoperative cyclosporine 2.0% versus betamethasone 0.1% eye drops following trabeculectomy: A randomized clinical trial.
Indian J Ophthalmol
October 2024
Department of Ophthalmology, Eye Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
Article Synopsis
- The study aimed to compare the effects of cyclosporine A 2% eye drops to steroid drops (betamethasone) on intraocular pressure (IOP) and success rates after trabeculectomy in patients with primary open-angle glaucoma.
- A total of 40 patients were randomly assigned to receive either cyclosporine A or steroid eye drops after surgery, with measurements of IOP and surgical success taken over a 24-month period.
- Results showed that the cyclosporine A group had significantly lower IOP, required fewer glaucoma medications, and had higher surgical success rates, along with reduced dry eye symptoms in the initial months after surgery.
Comparison between modified and conventional combined Trabeculotomy-Trabeculectomy with Mitomycin-C for intraocular pressure reduction in primary congenital glaucoma.
Pak J Med Sci
October 2024
Asad Aslam Khan. MBBS, MS Department of Ophthalmology, COAVS/KEMU, Lahore, Pakistan.
Article Synopsis
- The study aimed to compare the effectiveness of modified combined trabeculotomy-trabeculectomy (CTT) with mitomycin-C (MMC) versus conventional CTT with MMC in reducing intraocular pressure (IOP) in patients with primary congenital glaucoma (PCG).
- Conducted at The Institute of Ophthalmology, Lahore, from January 2018 to June 2019, the study included 70 patients aged 0 to 10 years, split into two groups for different surgical procedures.
- Results showed that while both procedures reduced IOP, conventional CTT with MMC was more effective, achieving a success rate of 71.4% compared to 40% for modified CTT.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!