AI Article Synopsis
- - The study aimed to evaluate how well the Ex-PRESS surgical procedure controlled intraocular pressure (IOP) in patients with open-angle glaucoma over three years, looking at factors affecting its success.
- - After the surgery, the average IOP significantly dropped, with cumulative success rates of 58%, 48%, and 30% depending on different IOP criteria.
- - One major finding was that needing additional bleb needling surgery after six months increased the risk of poor IOP control, indicating its importance in the postoperative care process.
Article Abstract
Purpose: To investigate the postoperative intraocular pressure (IOP) control and identify the factors associated with failure of initial Ex-PRESS surgery in patients with open-angle glaucoma for 3 years.
Methods: A total of 79 patients with medically uncontrolled open-angle glaucoma (55 normal-tension glaucoma and 24 primary open-angle glaucoma) were enrolled. All patients underwent Ex-PRESS implantation (including combined cataract surgery). The outcome measure was the survival rate using life table analysis, the failure was defined as IOP of > 18 mmHg (criterion A), > 15 mmHg (criterion B) or > 12 mmHg (criterion C) and/or IOP reduction of < 20% from baseline (each criterion) without any glaucoma medications. The Cox proportional hazards model was used to identify risk factors for IOP management defined as the above criterion. RESULTS: The mean preoperative IOP was 19.3 ± 5.8 mmHg. At 36 months, the mean IOP was 11.8 ± 3.6 mmHg with a mean IOP change of 7.5 mmHg (reduction rate 39.0%). The cumulative probability of success was 58% (95%CI: 42-64%) (criterion A), 48% (95%CI: 37-59%) (criterion B) and 30% (95%CI: 20-40%) (criterion C). In multivariate analyses, factors that predicted poor IOP control included the intervention of bleb needling after 6 months after the surgery (HR: 2.43; 95%CI: 1.35-4.37; P = 0.032). Transient hypotony was observed in 4 patients.
Conclusion: The implementation of bleb needling after Ex-PRESS surgery in the late postoperative period was suggested to be the main risk factor for achieving lower IOP.
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|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10806052 | PMC |
| http://dx.doi.org/10.1007/s00417-023-06209-8 | DOI Listing |
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