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Efficacy and Safety of the Express Implant in the Treatment of Primary and Secondary Glaucoma (pp. 187-196) $100.00
Authors:  (Begoña Arana Larrea, Sergio Pinar-Sueiro, Ana Orive Bañuelos , Ignacio Castresana Jauregui, Alejandro Fonollosa, Marta Galdós Iztueta, Bárbara Berasategui Fernández, Lorea Martinez-Indart, Nerea Martinez Alday, Department of Ophthalmology, Cruces Hospital, Vizcaya, Spain, and others)
Abstract:
Background: To assess the long-term efficacy and safety of ExPRESS glaucoma shunts under a sclera flap for the treatment of primary and secondary glaucoma.
Methods: Retrospective study of 100 patients in whom the ExPRESS device was implanted (mean follow-up period of 31.44 months). This surgery was combined with phacoemulsification and intraocular lens implantation in patients with visually significant cataract. The intraocular pressure (IOP) was measured after one, three, six and twelve months, as well as in the last visit prior to the data collection. Statistical analysis was carried out using the Student‘s t and Wilcoxon tests.
Results: The mean IOPs were 26.53, 18.21, 17.78, 17.65, 17.18 and 15.94 at baseline, one, three, six and twelve months and during the last visit, respectively. The number of glaucoma medications decreased from 2.55 preoperatively to 0.34, 0.93, 1.29, 1.48 and 1.76 at the same points postoperatively. The IOP reduced the most in cases of glaucoma with higher baseline IOP (pseudoexfoliative and secondary to prior surgery). The mean percentage decrease in the IOP after one year was 35.7%. It was observed that, though the IOP remained stable, for longer follow up periods the number of glaucoma medications required to control it progressively increased. The most common postoperative complication was flattening of the anterior chamber, that could be managed fairly easily.
Conclusions: The ExPRESS shunt is an effective and safe technique for the treatment of glaucoma, the best candidates for surgery being the subset of patients with the highest baseline IOP. 


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Efficacy and Safety of the Express Implant in the Treatment of Primary and Secondary Glaucoma (pp. 187-196)