Randomized Clinical Trial for Early Postoperative Complications of Ex-PRESS Implantation versus Trabeculectomy: Complications Postoperatively of Ex-PRESS versus Trabeculectomy Study (CPETS).

Shogo Arimura,Yoshihiro Takamura,Yuji Takihara,Takeshi Tomomatsu,Makoto Gozawa,Takehiro Matsumura,Seiji Miyake,Masaru Inatani,Kentaro Iwasaki

doi:10.1038/srep26080

Abstract

We compared early postoperative complications between trabeculectomy and Ex-PRESS implantation. Enrolled patients with 39 primary open-angle or 25 exfoliative glaucoma were randomly assigned to receive trabeculectomy (trabeculectomy group) or Ex-PRESS implantation (Ex-PRESS group). Primary outcomes were early postoperative complications, including postoperative anterior chamber inflammation, frequencies of hyphema, flat anterior chamber, choroidal detachment, hypotonic maculopathy, and the change of visual acuity. The postoperative flare values in trabeculectomy group were higher than those in the Ex-PRESS group (overall, P = 0.004; and 10 days, P = 0.02). Hyphema occurred significantly more frequently in the trabeculectomy group (P = 0.0025). There were no significant differences of the other primary outcomes between the two groups. Additionally, duration of anterior chamber opening was significantly shorter in the Ex-PRESS group (P = 0.0002) and the eyes that had iris contact with Ex-PRESS tube had significantly shallower anterior chambers than did the eyes without the iris contact (P = 0.013). The Ex-PRESS implantation prevented early postoperative inflammation and hyphema in the anterior chamber and shortened the duration of anterior chamber opening. Iris contact with the Ex-PRESS tube occurred more frequently in eyes with open-angle glaucoma and shallow anterior chambers.

Highlights

IntroductionWe compared early postoperative complications between trabeculectomy and Ex-PRESS implantation
Two meta-analyses that included four previous prospective studies have illustrated that Ex-PRESS implantation provided intraocular pressure (IOP) reduction comparable to that provided by trabeculectomy; they caused fewer anterior chamber hyphemas than those caused by trabeculectomy[13,14]
The main aim of our present study was the comparison of the frequency of early postoperative complications between trabeculectomy and Ex-PRESS implantation

Summary

Introduction

We compared early postoperative complications between trabeculectomy and Ex-PRESS implantation. The Ex-PRESS implantation prevented early postoperative inflammation and hyphema in the anterior chamber and shortened the duration of anterior chamber opening. Trabeculectomy is the gold-standard filtering surgery for intraocular pressure (IOP) reduction in glaucoma patients[1]. In this procedure, the surgeon creates a scleral flap for the drainage of the aqueous humor and subsequent bleb formation. Two meta-analyses that included four previous prospective studies have illustrated that Ex-PRESS implantation provided IOP reduction comparable to that provided by trabeculectomy; they caused fewer anterior chamber hyphemas than those caused by trabeculectomy[13,14]

Objectives

Methods

Conclusion