ANALYSIS OF HYPOTENSIVE EFFECT OF EX-PRESS DRAINAGE DEVICE FOR REFRACTORY GLAUCOMA

Abstract

Purpose: to analyze the effectiveness of Ex-Press drainage device implantation for refractory glaucoma of different origin for 3 years.Patients and methods: The study consisted of 82 patients (86 eyes) with refractory glaucoma aged 26–86 years (67.37±0.53). Pre-operative IOP level averaged 37.8±1.04 mm Hg. Ex-Press drainage device implantation was rated according to the following criteria: IOP, time course of visual functions, the need for additional drug therapy and reoperation, the presence of intraoperative and postoperative complications. Examination of the patients was carried out from 1 to 8 days after the surgery and within 1, 3, 6, 12, 24 and 36 months.Results: According to our research results relative hypotensive effect equaled 74.4% (64/86) within a year after the surgery; 67.4% (58/86) — within 2 years; 65.1% (56/86) — after 3 years of follow-up period. The maximum decrease in IOP by 61.6% was observed immediately after the surgery. There was no effect of surgical treatment within3 years in 34.9% (30/86). Complications were observed in 23.2% (20/86) of cases: choroidal detachment — 12.8% (11/86), hyphema — 3.5% (3/86), eruption and dislocation — 3.5% (3 / 86), delayed expulsive hemorrhage — 2.3% (2/86), cyst of filtering bleb — 1.2% (1/86).Conclusion. Fistulizing operations with implantation of Ex-Press drainage device for refractory glaucoma provide normalization of IOP in 65.1% of cases (including 15.1% on the background of additional drug therapy) at follow-up period up to 3 years.

Keywords

• refractory glaucoma
• drainage glaucoma surgery
• ex-press drainage device
• long-term results