Clinical observation express~(TM) for refractory glaucoma

Objective:To study and evaluate the outcome of Express~(TM) Claucoma Valve Implantation for refractory glaucoma. Methods:Cases series included the eyes of Caucasian patients with refractory glaucoma,operated between 01.2003—10.2004. There were 41 eyes. The Ex-PRESS~(TM) devices were inserted under the sclera flap and into the anterior chamber.If necessary anti-metabolile (MMc or 5-Fu) was used under the sclera flap before injecting the device. Each patient underwent ophthalmic examinations (Vision,IOP,visual field,gonioscopy,cup/disc ratio) before and after the operation. The longest postoperative follow-up period was 12 months. Resultes:The IOP decreased from 24.1±4.62mm Hg pre-operatively to 14.65±1.96mmHg at 26 weeks amt 13.81±1.91mmHg at one year. Success rate was 90.2% (IOP below 20 mm Hg with or without drugs). Complete success was 80% (IOP below 20 mm Hg without anti-glaucoma drops or medications). In 4 eyes IOP was not controlled with eyes drops,and the eves had already been re-operated. 3 cases had an athalamy in anterior chamber but recovered soon by treatment. None of the patients developed infection or irreversible damage to the eye. No case was found to have erosion. Conclusions:the safety and efficacy of the device ureter a sclera flap have been demonstrated in glaucoma surgery in this study.