Indications and postoperative treatment for Ex-PRESS^® insertion in Japanese patients with glaucoma: comparison with standard trabeculectomy

Figures & data

Figure 1 Changes in mean postoperative IOP in all patients.

Notes: No significant intergroup differences were seen at any observation point (Mann–Whitney U-test). The 95% confidence interval for the mean IOP at 6 months after surgery was 16.7 (13.2–20.2) mmHg in the Ex-PRESS^® group and 14.9 (12.7–17.1) mmHg in the TLE group.
Abbreviations: IOP, intraocular pressure; TLE, trabeculectomy.

Figure 2 Changes in mean postoperative IOP for patients with primary open-angle glaucoma.

Notes: No significant intergroup differences were seen at any observation point (Mann–Whitney U-test). The 95% confidence interval for the mean IOP at 6 months after surgery was 14.4 (8.6–20.3) mmHg in the Ex-PRESS^® group and 11.8 (7.9–15.7) mmHg in the TLE group.
Abbreviations: IOP, intraocular pressure; TLE, trabeculectomy.

Figure 3 Changes in mean postoperative IOP for patients with neovascular glaucoma.

Notes: No significant intergroup differences were seen at any observation point (Mann–Whitney U-test). The 95% confidence interval of mean IOP at 6 months after surgery was 19.6 (10.0–29.2) mmHg in the Ex-PRESS^® group and 18.0 (11.9–24.1) mmHg in the TLE group.
Abbreviations: IOP, intraocular pressure; TLE, trabeculectomy.

Table 1 Patient characteristics and study follow-up

Patient characteristics	Ex-PRESS^® group	TLE group	P-value
Age (years), mean ± SD	66.7±12.6	67.5±12.0	0.99a
Sex (male/female), n	13/8	15/7	0.75b
Eyes (right/left), n	12/9	13/9	1.00b
Eyes with previous intraocular surgery
TLE, n	2	5	0.41b
Vitrectomy, n	6	2	0.13b
Preoperative IOP (mmHg), mean ± SD	29.9±7.8	31.9±10.3	0.47a
Total follow-up (days), mean ± SD	125.6±73.8	158.5±55.5	0.08a

Notes:

a Mann–Whitney U-test;

b Fisher’s Exact test.

Abbreviations: IOP, intraocular pressure; TLE, trabeculectomy.

Table 2 Type of glaucoma

Type of glaucoma	Ex-PRESS^® group, n (%)	TLE group, n (%)	P-value
Primary glaucoma
Primary open-angle glaucoma	8 (38.1)	7 (31.8)	0.75
Plateau iris	1 (4.8)	0	0.49
Secondary glaucoma
Neovascular glaucoma	7 (33.3)	6 (27.3)	0.75
Steroid-induced glaucoma	1 (4.8)	0	0.49
Pseudoexfoliation glaucoma	0	5 (22.7)	0.05
Glaucoma after vitrectomy	1 (4.8)	0	0.49
Uveitic glaucoma	2 (9.5)	2 (9.1)	1.00
Peripheral anterior synechia	1 (4.8)	2 (9.1)	1.00
Total	21	22

Note: No significant intergroup differences were seen for any item (Fisher’s Exact test).

Abbreviation: TLE, trabeculectomy.

Figure 4 Changes in mean postoperative IOP in patients with POAG or NVG in the Ex-PRESS^® group.

Notes: No significant intergroup differences were seen at any observation point (Mann–Whitney U-test). The 95% confidence interval for mean IOP at 6 months after surgery was 14.4 (8.6–20.2) mmHg in the Ex-PRESS^® group and 19.6 (10.0–29.2) mmHg in the TLE group.
Abbreviations: IOP, intraocular pressure; TLE, trabeculectomy; POAG, primary open-angle glaucoma; NVG, neovascular glaucoma.

Figure 5 Complete success rate after surgery, as measured by the percentage of patients with a postoperative IOP less than 30% of the preoperative IOP.

Notes: No significant intergroup differences in success rate were seen at any observation point (log rank test, P=0.84). The success rate at 6 months after surgery was 48.5% in the Ex-PRESS^® group and 53.0% in the TLE group.
Abbreviations: IOP, intraocular pressure; TLE, trabeculectomy.

Figure 6 Qualified success rate after surgery, as measured by the percentage of patients with a postoperative IOP less than 30% of the preoperative IOP.

Notes: No significant intergroup differences in success rate were seen at any observation point (log rank test, P=0.89). The success rate at 6 months after surgery was 70.6% in the Ex-PRESS^® group and 71.4% in the TLE group.
Abbreviations: IOP, intraocular pressure; TLE, trabeculectomy.

Figure 7 Complete success rate after surgery, as measured by the percentage of patients with a postoperative IOP between 5 and 21 mmHg.

Notes: No significant intergroup differences in success rate were seen at any observation point (log rank test, P=0.99). The success rate at 6 months after surgery was 37.1% in the Ex-PRESS^® group and 45.5% in the TLE group.
Abbreviations: IOP, intraocular pressure; TLE, trabeculectomy.

Figure 8 Qualified success rate after surgery, as measured by the percentage of patients with a postoperative IOP between 5 and 21 mmHg.

Notes: No significant intergroup differences in success rate were seen at any observation point (log rank test, P=0.12). The success rate at 6 months after surgery was 46.8% in the Ex-PRESS^® group and 71.4% in the TLE group.
Abbreviations: IOP, intraocular pressure; TLE, trabeculectomy.

Table 3 Postoperative complications

Postoperative complications	Ex-PRESS^® group, n (%)	TLE group, n (%)	P-value
Shallow anterior chamber	9 (42.9) 10 (45.5)		1.00
Hypotony (<5 mmHg)	11 (52.4)	11 (50.0)	0.76
Choroidal detachment	9 (42.9)	8 (36.4)	0.75
Hyphema	2 (9.5)	11 (50.0)	0.006^*
Postoperative endophthalmitis	0 (0)	0 (0)	1.00
Bleb leak	2 (9.5)	0 (0)	0.23
Choroidal detachment	9 (42.9)	11 (50)	0.76
Contact between the device and iris	8 (38.1)

Note: The incidence of hyphema was significantly lower in the Ex-PRESS^® group than in the TLE group (^*Fisher’s Exact test).

Abbreviation: TLE, trabeculectomy.

Table 4 Postoperative treatment

Postoperative treatment	Ex-PRESS^® group, n (%)	TLE group, n (%)	P-value
Laser suture-lysis	6 (28.6)	11 (52.4)	0.21
Needling	1 (4.8)	2 (9.1)	0.61
Anterior chamber wash-out	0 (0)	1 (4.5)	1.00
Glaucoma eye drop administration	8 (42.9)	7 (31.9)	0.53

Note: No significant intergroup differences were seen for any item (Fisher’s Exact test).

Abbreviation: TLE, trabeculectomy.

Table 5 Height of the filtering bleb

Filtering bleb height	Ex-PRESS^® group, n (%)	TLE group, n (%)	P-value
Flat	9 (42.9)	2 (9.1)	0.03^*
Low	3 (14.3)	3 (13.6)	1.00
High	9 (42.9)	17 (77.3)	0.08

Note: The number of eyes with a flat filtering bleb differed slightly between the Ex-PRESS^® and TLE groups (^*Fisher’s Exact test).

Abbreviation: TLE, trabeculectomy.

Table 6 Comparison of postoperative complications and treatment for patients in the Ex-PRESS^® group with primary open-angle glaucoma or neovascular glaucoma

Postoperative complications and treatment	Primary open-angle glaucoma, n (%)	Neovascular glaucoma, n (%)	P-value
Shallow anterior chamber	3 (37.5)	4 (57.1)	0.62
Hypotony (<5 mmHg)	5 (75)	4 (57.1)	1.00
Choroidal detachment	3 (37.5)	4 (57.1)	0.62
Hyphema	0 (0)	1 (14.3)	0.47
Contact between the device and iris	4 (50)	2 (28.6)	0.61
Laser suture-lysis	4 (50)	0 (0)	0.07
Glaucoma eye drop administration	3 (37.5)	5 (71.4)	0.31

Note: No significant intergroup differences were seen for any item (Fisher’s Exact test).