The Clinical Evaluation Of Ex-PRESS Glaucoma Miniature Drainage Device For The Surgical Treatment Of Complexity Glaucoma

Objective.To observe and investigate the efficacy and safety of glaucoma miniature drainage device for the surgical treatment of complexity glaucoma.Methods.This retrospective analysis comprised 40 eyes of 37 patients who were suffered from complexity glaucoma and treated with Ex-PRESS miniature glaucoma device implantation in July 2016 to February 2018 in our Hospital.The successful rate,intraocular pressure(IOP),the postoperative anti-glaucoma medications,visual acuity,postoperative complications were recorded and statistically analyzed preoperative and3d,1w,1,2,3 and 6mon after operation.Also,we compared the efficacy between NVG group and other types group,simple Ex-PRESS surgery group and Combined surgery group.Results.The postoperative success rate at 3d,1wk,1,2,3 and 6mo was 95%,87.5%,54.1%,46.2%,54.5%,66.7%.Postoperative lOP at each review time was significantly decreased when compared to preoperation(P<0.01).There was no difference between NVG group and other types group.The number of anti-glaucoma drugs was significantly reduce after surgery(χ~2=21.618,P<0.05).There was no significant difference after Ex-PRESS device treatment.There was no difference between NVG group and other types group.The number of anti-glaucoma drugs was significantly reduce after surgery(χ~2=21.618,P<0.05).However,we find statistically significant in visual acuity after 1 month between the simple Ex-PRESS miniature glaucoma drainage device implantation group and combined with phacoemulsification and intraocular lens implantation group(χ2=5.064,P<0.05),while Preoperative visual acuity was not(χ~2=3.061,P=0.080).The complications mainly included transient low IOP in 2 eyes,postoperative hyphema in 1 eye,non-functional bleb in 3 eyes,iris blockage at the entrance of drainage nail in 1 eye,two another eyes need reoperation.There was no serious complication happened.Conclusion.The Ex-PRESS miniature glaucoma drainage device implantation is an effective method for controlling IOP in the treatment of refractory glaucoma.The operation of Ex-PRESS implantation combined with Phaco+IOL implantation,which can reduce IOP and improve visual acuity evidently with less complications,is a safe and effective combined operation for glaucoma with cataract.