Clinical Interventions in Aging (Apr 2017)
Evaluation of EX-PRESS glaucoma implant in elderly diabetic patients after 23G vitrectomy
Abstract
Anita Lyssek-Boroń,1 Adam Wylęgała,1 Dariusz Dobrowolski,1,2 Ewelina Kowalczyk,1 Katarzyna Polanowska,1 Edward Wylęgała1,2 1Department of Ophthalmology with Pediatric Unit, Trauma Center, Santa Barbara Hospital, Sosnowiec, 2Department of Ophthalmology, Ophthalmology Clinic, Medical University of Silesia, District Railway Hospital, Katowice, Poland Purpose: The most frequent qualifications for pars plana vitrectomy (PPV) in diabetic patients include recurrent hemorrhage into the vitreous body chamber and vitreoretinal proliferation, also with traction retinal detachment. The aim of this study was to evaluate the effectiveness of EX-PRESS implant for the treatment of secondary glaucoma in elderly diabetic patients following PPV 23G with silicon oil or SF6 gas endotamponade.Materials and methods: This retrospective analysis comprised 18 patients (19 eyes). We applied EX-PRESS implants in 9 patients with neovascular glaucoma (NVG) and in 10 patients with non-NVG. All patients had earlier history of diabetes and vitrectomy 23G for diabetic complications. Intraocular pressure (IOP) was measured and compared before; 7 days; 1, 3, 6, and 12 months; and a year after the surgery.Results: Application of the implant exhibited a lowering effect on IOP. After 1 month, 53% of patients had IOP values beyond 22 mmHg, while 86% after 1 year.Conclusion: The implant can be used to treat both NVG and non-NVG in diabetic patients following PPV. Keywords: PPV, glaucoma surgery, DM, IOP
