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01-06-2020 | Glaucoma | Original Paper

Comparison of the 1-year postoperative results of phacoemulsification–trabeculectomy and phacoemulsification–ExPRESS miniature shunt combined surgeries

Authors: Kemal Turgay Özbilen, Şerife Bayraktar, Emre Altınkurt, Mehmet Cemil Yılmazlı, Muhammed Talha Sadık, Ali Üstüner

Published in: International Ophthalmology | Issue 6/2020

Abstract

Background and objective

This study aimed to compare the 1-year postoperative phacoemulsification–trabeculectomy (P-Trab) and phacoemulsification–ExPRESS^® (P-200 model) miniature shunt (P-ExPRESS) combined surgeries.

Materials and methods

This retrospective, comparative clinical study investigated 41 eyes of 41 patients diagnosed with open-angle glaucoma and cataract. Of these, 21 eyes underwent P-Trab surgery and 20 eyes underwent P-ExPRESS surgery. The 1-year follow-up results, including intraocular pressure (IOP), visual acuity (VA), medications, and complications, were reviewed and compared. A 5 ≤ IOP ≤ 18 mmHg or 30% reduction from baseline was defined as Qualified Success (QS-1), and target IOP without medication was defined as Complete Success (CS-1). A 5 ≤ IOP ≤ 15 mmHg or 40% reduction from baseline was defined as Qualified Success (QS-2), and target IOP without medication was defined as Complete Success (CS-2).

Results

The mean follow-up time was 16 months (12–26 months). Results after the twelfth month for P-Trab versus P-ExPRESS are: CS-1: 42.8% versus 60.0% (P = 0.354); QS-1: 86.7% versus 95% (P = 0.606); CS-2:33.3% versus 40% (P = 0.751); QS-2: 66.6% versus 75% (P = 0.733). Kaplan–Meier survival analysis was not statistically significant between two groups for both QS-1, CS-1 and QS-2, CS-2 (P = 0.329 vs P = 0.365, P = 0.765 vs P = 0.789, respectively). Pre-op mean IOP was: 33.19 ± 8.7 versus 34.55 ± 11.3 mmHg; post-op mean IOP was: 15.19 ± 3.07 versus 15.30 ± 3.32 mmHg (P = 0.913); pre-op mean VA was: 1.17 ± 1.04 versus 1.15 ± 1.07 logMAR; and post-op mean VA was: 0.61 ± 0.80 versus 0.66 ± 0.99 logMAR (P = 0.869). The pre-op mean number of antiglaucomatous medications was 3.76 ± 0.53 versus 3.30 ± 1.45, and the post-op results were 1.52 ± 1.53 versus 0.85 ± 1.26 (P = 0.135). Comparing the pre-op and post-op values, both types of surgeries were equally effective (P = 0.00). Surgical failure was 14.2% (3/21) versus 5% (1/20), and the incidence ratios of significant complications were: 47% (10/21) versus 10% (2/20) and P-Trab versus P-ExPRESS, respectively (P = 0.015).

Conclusion

The 1-year postoperative results suggest that P-ExPRESS is as effective as P-Trab, with fewer complications.

European Glaucoma Society (2014) Terminology and guidelines for glaucoma, chapter 2, 4th edn. European Glaucoma Society, Brussels, p 79

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Title: Comparison of the 1-year postoperative results of phacoemulsification–trabeculectomy and phacoemulsification–ExPRESS miniature shunt combined surgeries
Authors: Kemal Turgay Özbilen
Şerife Bayraktar
Emre Altınkurt
Mehmet Cemil Yılmazlı
Muhammed Talha Sadık
Ali Üstüner
Publication date: 01-06-2020
Publisher: Springer Netherlands
Keywords: Glaucoma
Trabeculectomy
Cataract
Published in: International Ophthalmology / Issue 6/2020
Print ISSN: 0165-5701
Electronic ISSN: 1573-2630
DOI: https://doi.org/10.1007/s10792-020-01321-8

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Conclusion

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