Conventional trabeculectomy versus trabeculectomy with the Ex-PRESS^® mini-glaucoma shunt: differences in postoperative interventions

Figures & data

Table 1 The characteristics of the 108 glaucoma patients who underwent a conventional trabeculectomy or trabeculectomy with an Ex-Press

Characteristics	Conventional	Ex-Press	p-value
No of patients	39	69
Males/females	24/15	31/38	0.28
Age, years	70.0±13.7	70.3±8.6	0.877
Pre IOP, mmHg	27.8±7.9	27.7±9.2	0.919
No of medications	3.8±0.6	4.1 ±1.1	0.102
Follow-up, months	37.8± 14.2	31.1 ± 13.1	0.0093
CCT, μm	528±45	535±38	0.352
Scleral flap sutures	4.3± 1.0	2.7± 1.0	<0.001
Triple surgery	20.5% (8/39)	26.1% (18/69)	0.761
Subtypes of glaucoma
POAG	35.9% (14/39)	37.7% (26/69)	1.00
PEX	41.0% (16/39)	60.8% (42/69)	0.07
SG	20.5% (8/39)	1.4% (1/69)	0.0011
PACG	2.6% (1/39)	0% (0/84)	0.361

Note: Triple surgery: trabeculectomy and phacoemulsification + intraocular lens implantation simultaneously.

Abbreviations: CCT, central corneal thickness; Ex-Press, ex-press® mini-glaucoma shunt device; IOP, intraocular pressure; PACG, primary angle closure glaucoma; PEX, pseudo-exfoliation; POAG, primary open angle glaucoma; sg, secondary glaucoma.

Table 2 The postoperative data (IOP and no. of medications) of the conventional and Ex-Press groupsa

	IOP, mmHg			No of medications
	Conventional	Ex-Press	p-value	Conventional	Ex-Press	p-value
Pre-IOP (no of eyes)	27.8±7.9 (39)	27.7±9.2 (69)	0.919	3.8±0.6 (39)	4.1±1.1 (69)	0.102
1 year	11.1±3.9 (34)	11.5±3.7 (60)	0.612	1.4±1.6 (34)	1.6±1.7 (60)	0.560
2 years	11.4±3.1 (30)	11.9±3.5 (34)	0.519	1.5±1.6 (30)	2.2±1.7 (34)	0.129
3 years	12.5±3.0 (18)	11.5±3.3 (21)	0.319	2.1±1.5 (18)	2.3±1.7 (21)	0.648
4 years	13.0±3.4 (12)	10.9±3.4 (8)	0.178	2.3±1.5 (12)	2.4±2.0 (8)	0.876
5 years	11.0±3.5 (5)	8.5±0.7 (2)	0.390	2.4±1.3 (5)	2.0±2.8 (2)	0.795

Note:

a The results of the eyes that underwent additional glaucoma surgeries were excluded.

Abbreviations: Ex-Press, Ex-PRESS^® mini-glaucoma shunt device; IOP, intraocular pressure.

Table 3 Comparison of the results between Single and Triple surgeries

	Single surgery	Triple surgery	p-value
Preoperation
IOP	27.6±8.4 (82)	27.9±9.7 (26)	0.886
Medications	4.0±1.0	4.0±0.8	0.871
1 year
IOP	11.1±4.1 (72)	12.3±2.4 (22)	0.188
Medications	1.4±1.6	1.5±1.7	0.841
2 years
IOP	11.4±3.4 (50)	12.8±2.9 (14)	0.163
Medications	1.9±1.7	1.6±1.7	0.564
3 years
IOP	11.9±3.3 (29)	12.2±2.9 (11)	0.74
Medications	2.1±1.6	2.3±1.7	0.814
4 years
IOP	12.7±5.5 (16)	12.6±3.2 (5)	0.974
Medications	2.1±1.7	3.0±1.7	0.297
5 years
IOP	10.0±3.1 (7)	None
Medications	2.3±1.6

Abbreviation: IOP, intraocular pressure.

Figure 1 (A) Kaplan–Meier survival curves for Criterion A (postoperative IOP ≤21 mmHg or ≥20% reduction from the baseline). (B) Kaplan–Meier survival curves for Criterion B (postoperative IOP ≤15 mmHg or $20% reduction from the baseline).

Note: There was no significant difference in the success rate between the conventional and Ex-Press groups in Criterion A (p=0.570) or Criterion B (p=0.991).
Abbreviations: Ex-Press, Ex-PRESS^® mini-glaucoma shunt device; IOP, intraocular pressure.

Table 4 Comparison of postoperative interventions between conventional trabeculectomy and trabeculectomy with Ex-Press

	Conventional	Ex-Press	p-value
Laser suture lysis executed (eyes)	66.6% (26/39)	84.1% (58/69)	0.0368
No of sutured threads (eyes)	4.4±1.1 (26)	2.7±1.1 (58)	<0.0001
No of cut threads (eyes)	2.7±1.4 (26)	2.4±1.0 (58)	0.297
No of cut threads/No of sutured threads (eyes)	61.2±26.3 (26)	89.2±20.0 (58)	<0.0001
No of days until cutting the first thread (eyes)	8.8±10.6 (26)	3.4±4.3 (58)	0.0012
No of days until cutting the second thread (eyes)	11.9±10.9 (20)	12.2±11.4 (53)	0.904
Needling executed (eyes)	23.0% (9)	15.9% (11)	0.359
No of days until needling	32.5±15.8	29.2±18.9	0.691
IOP before needling	23.6±3.1 mmHg	22.0±5.1 mmHg	0.434
IOP 1 month after needling (eyes) (rate of decrease)	17.2±6.9 mmHg (9) (27.6%±22.0%)	17.6±4.6 mmHg (11) (16.9%±21.7%)	0.874 (0.292)
IOP 3 months after needling (eyes) (rate of decrease)	13.1±3.0 mmHg (7) (41.1%±15.8%)	12.0±2.9 mmHg (8) (40.2%±18.6%)	0.467 (0.917)
IOP 6 months after needling (eyes) (rate of decrease)	13.1±3.0 mmHg (7) (40.5%±17.7%)	11.5±2.3 mmHg (8) (42.1%±19.1%)	0.251 (0.872)

Abbreviations: Ex-Press, Ex-PRESS^® mini-glaucoma shunt device; IOP, intraocular pressure.

Table 5 Comparison of complications between conventional trabeculectomy and trabeculectomy with Ex-Press

	Conventional	Ex-Press	p-value
Shallow anterior chamber	7.7% (3/39)	2.9% (2/69)	0.255
Hypotonic maculopathy	5.1% (2/39)	0% (0/69)	0.0576
Choroidal detachment	33.3% (13/39)	15.9% (11/69)	0.0368
Hyphema	7.7% (3/39)	1.4% (1/69)	0.0989
Corneal edema	2.6% (1/39)	1.4% (1/69)	0.680
Suprachoroidal hemorrhage	2.6% (1/39)	0% (0/69)	0.181
Endophthalmitis	0% (0/39)	0% (0/69)	–

Note: Data presented as percentage (eyes).

Abbreviation: Ex-Press, Ex-PRESS^® mini-glaucoma shunt device;