Background: In this study, we compared the efficacy of Ahmed, Ex-PRESS, and trabeculectomy to provide a reference for determining surgical schemes for glaucoma patients undergoing external drainage surgery in clinical practice.
Methods: We performed a literature search for studies on the treatment of primary and secondary glaucoma with three types of external drainage surgery (Ahmed, Ex-PRESS, and trabeculectomy). As at April 24, 2021, seven electronic databases were searched for randomized controlled trials comparing any two of Ahmed, Ex-PRESS, and trabeculectomy in the treatment of glaucoma. The Cochrane tool was also adopted to evaluate the risk of bias in these trials. The relative risk (RR) with 95% confidence interval (CI), and weighted mean difference (WMD) were determined and compared indirectly using R software.
Results: A total of 14 randomized controlled trials were included in this study, involving 866 eyes of 808 patients. As for the intraocular pressure (IOP) after 3 months, trabeculectomy did not contribute to better improvement than Ahmed (WMD =0.014; 95% CI: -0.14-0.18) and Ex-PRESS (WMD =0.014; 95% CI: -0.072-0.097). However, there was a significant difference in the IOP 1 year between trabeculectomy and Ex-PRESS (WMD =0.097; 95% CI: 0.0080-0.18), with the latter achieving a favorable improvement effect. Meanwhile, the complete success (CS) of trabeculectomy was significantly lower than that of Ex-PRESS (RR =0.73; 95% CI: 0.57-0.93). In addition, Ex-PRESS was superior to Ahmed (WMD =-0.48; 95% CI: -0.89 to -0.084) in terms of a decreased number of post-operative medications.
Discussion: For glaucoma patients who are required to receive external drainage surgery, Ex-PRESS could achieve a significant effect on the IOP 1 year and CS, as well as a marked decrease in the number of post-operative medications used, compared with the other two types of surgery. In terms of the efficacy at least 1 year after surgery, Ex-PRESS should be one of the preferred methods for external drainage.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.21037/apm-21-3968 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Compared to Trabeculectomy, Ex-Press Surgery Significantly Decreased the Loss of Corneal Endothelial Cell Density in Low-Intraocular-Pressure Glaucoma: 3-Year Follow-Up.
Clin Ophthalmol
October 2024
Department of Ophthalmology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan.
Article Synopsis
- A study was conducted to compare the loss of corneal endothelial cells in glaucoma patients who underwent trabeculectomy (Trab) versus Ex-Press surgery (EXP).
- The research involved analyzing patient data over a three-year period, measuring corneal endothelial cell density (CED) before and after surgery using specialized microscopy.
- Results showed that EXP surgery led to significantly less cell loss compared to Trab, suggesting that EXP is a safer option in terms of preserving corneal health.
Comparison of corneal endothelial cell density reduction between primary open-angle glaucoma and pseudo-exfoliation glaucoma patients at 3 years after Ex-Press® surgery.
Int Ophthalmol
July 2024
Department of Ophthalmology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, 2630 Sugitani, Toyama City, 930-0194, Japan.
Article Synopsis
- The study aimed to compare corneal endothelial cell (CED) loss after Ex-Press surgery in patients with primary open-angle glaucoma (POAG) versus pseudo-exfoliation glaucoma (PEX).
- A total of 119 eyes were analyzed over more than three years to measure CED before and after surgery using noncontact specular microscopy.
- Results showed that PEX patients experienced a more significant decline in CED compared to POAG patients, with a lower CED survival ratio in the PEX group after three years.
Comparison of bleb morphologies between phacoemulsification combined with Ex-PRESS mini shunt implantation, phacotrabeculectomy and trabeculectomy alone: a two-year retrospective in vivo confocal microscopy study.
BMC Ophthalmol
March 2024
Department of Ophthalmology, Nanfang Hospital, Southern Medical University, No. 1838 Guangzhou Dadao North Road, 510000, Guangzhou, China.
Background: To compare the bleb morphologies of phacoemulsification combined with Ex-PRESS implantation (Phaco-ExPRESS), phaco trabeculectomy (Phaco-Trab), and trabeculectomy (Trab) in postoperative two years.
Methods: Patients with primary open-angle glaucoma (POAG) with or without cataracts were included in this study. All patients underwent surgeries of either Phaco-ExPRESS, Phaco-Trab, or Trab.
Clinical analysis of infectious endophthalmitis following glaucoma filtration surgery.
J Ophthalmic Inflamm Infect
February 2024
Department of Ophthalmology & Visual Science, Eye Institute, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, 200031, China.
Background: This study aimed to evaluate the clinical correlative factors and outcomes of treatment of bleb-associated endophthalmitis (BAE) following glaucoma filtration surgery in a Chinese population from the year 2012 to 2022, and to compare them with the clinical course during the coronavirus disease (COVID-19) pandemic period.
Methods: This was a retrospective analysis of consecutive cases of BAE treated at the Eye & ENT Hospital of Fudan University, Shanghai, China, between January 1, 2012, and December 31, 2022. The clinical presentation, treatment modality, microbiological data, clinical course, and outcomes of visual acuity (VA) and intraocular pressure (IOP) in all BAE cases were collected and analyzed.
Surgical Outcomes in Uveitic Glaucoma: Long-Term Evaluation of Trabeculectomy, Non-Penetrating Deep Sclerectomy, Ex-PRESS Shunt and Ahmed Glaucoma Valve. A 3-Year Follow-Up Study.
Ocul Immunol Inflamm
November 2024
Ophthalmology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
Purpose: Uveitis can lead to secondary glaucoma, a condition with challenging management that can carry irreversible visual loss. Filtering surgery has demonstrated a higher failure rate, increased incidence of postoperative complications and reinterventions in uveitic patients. There is no consensus on the optimal surgical approach for uveitic glaucoma (UG) due to limited data comparing various intraocular pressure (IOP)-lowering surgeries.
View Article and Find Full Text PDFWant 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!