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Ex-PRESS Miniature Glaucoma Shunt for the Treatment of Uveitic Glaucomas

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Advanced Glaucoma Surgery

Part of the book series: Essentials in Ophthalmology ((ESSENTIALS))

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Abstract

The Ex-PRESS mini-glaucoma device is an alternative to traditional trabeculectomy. The device has been found to be safe, as efficacious and even superior to trabeculectomy in some aspects. For complex glaucomas, the Ex-PRESS should be considered as an alternative to glaucoma drainage implants. Winston Churchill once said, “Without tradition, art is a flock of sheep without a shepherd. Without innovation, it is a corpse.” Often in times of technological advance, progress requires a melding of tradition and innovation. Ophthalmology and glaucoma surgery are no different. Amidst a flood of minimally invasive glaucoma surgical advancements, filtration and shunt surgeries remain steadfast as definitive therapies for severe glaucoma. Trabeculectomy has remained the gold standard for glaucoma surgery; however, advances in surgical technique have even come to this decades-old procedure. The Ex-PRESS Mini-Glaucoma Device is now accepted in many circles as a modification of the trabeculectomy procedure available to many patients.

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References

  1. Geffen N, Trope GE, Alasbali T, Salonen D, Crowley AP, Buys YM. Is the Ex-PRESS glaucoma shunt magnetic resonance imaging safe? J Glaucoma. 2010;19(2):116–8. doi:10.1097/IJG.0b013e3181a98bda.

    PubMed  Google Scholar 

  2. Nyska A, Glovinsky Y, Belkin M, Epstein Y. Biocompatibility of the Ex-PRESS miniature glaucoma drainage implant. J Glaucoma. 2003;12(3):275–80.

    Article  PubMed  Google Scholar 

  3. Gandolfi S, Traverso CF, Bron A, Sellem E, Kaplan-Messas A, Belkin M. Short-term results of a miniature draining implant for glaucoma in combined surgery with phacoemulsification. Acta Ophthalmol Scand Suppl. 2002;236:66.

    Article  CAS  PubMed  Google Scholar 

  4. Stewart RM, Diamond JG, Ashmore ED, Ayyala RS. Complications following ex-press glaucoma shunt implantation. Am J Ophthalmol. 2005;140(2):340–1. doi:10.1016/j.ajo.2005.02.033.

    Article  PubMed  Google Scholar 

  5. Traverso CE, De Feo F, Messas-Kaplan A, Denis P, Levartovsky S, Sellem E, Badala F, Zagorski Z, Bron A, Gandolfi S, Belkin M. Long term effect on IOP of a stainless steel glaucoma drainage implant (Ex-PRESS) in combined surgery with phacoemulsification. Br J Ophthalmol. 2005;89(4):425–9. doi:10.1136/bjo.2004.058032.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  6. Wamsley S, Moster MR, Rai S, Alvim HS, Fontanarosa J. Results of the use of the Ex-PRESS miniature glaucoma implant in technically challenging, advanced glaucoma cases: a clinical pilot study. Am J Ophthalmol. 2004;138(6):1049–51. doi:10.1016/j.ajo.2004.06.024.

    Article  PubMed  Google Scholar 

  7. Dahan E, Carmichael TR. Implantation of a miniature glaucoma device under a scleral flap. J Glaucoma. 2005;14(2):98–102.

    Article  PubMed  Google Scholar 

  8. Beltran-Agullo L, Trope GE, Jin Y, Wagschal LD, Jinapriya D, Buys YM. Comparison of visual recovery following Ex-PRESS versus trabeculectomy: results of a prospective randomized controlled trial. J Glaucoma. 2013. doi:10.1097/IJG.0b013e31829e1b68.

    PubMed  Google Scholar 

  9. Netland PA, Sarkisian Jr SR, Moster MR, Ahmed II, Condon G, Salim S, Sherwood MB, Siegfried CJ. Randomized, prospective, comparative trial of EX-PRESS glaucoma filtration device versus trabeculectomy (XVT study). Am J Ophthalmol. 2014;157(2):433–40. doi:10.1016/j.ajo.2013.09.014. e433.

    Article  PubMed  Google Scholar 

  10. Sugiyama T, Shibata M, Kojima S, Ueki M, Ikeda T. The first report on intermediate-term outcome of Ex-PRESS glaucoma filtration device implanted under scleral flap in Japanese patients. Clin Ophthalmol. 2011;5:1063–6. doi:10.2147/OPTH.S23129.

    Article  PubMed Central  PubMed  Google Scholar 

  11. Dahan E, Ben Simon GJ, Lafuma A. Comparison of trabeculectomy and Ex-PRESS implantation in fellow eyes of the same patient: a prospective, randomised study. Eye (Lond). 2012;26(5):703–10. doi:10.1038/eye.2012.13.

    Article  CAS  Google Scholar 

  12. Wang W, Zhou M, Huang W, Zhang X. Ex-PRESS implantation versus trabeculectomy in uncontrolled glaucoma: a meta-analysis. PLoS One. 2013;8(5):e63591. doi:10.1371/journal.pone.0063591.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  13. Kanner EM, Netland PA, Sarkisian Jr SR, Du H. Ex-PRESS miniature glaucoma device implanted under a scleral flap alone or combined with phacoemulsification cataract surgery. J Glaucoma. 2009;18(6):488–91. doi:10.1097/IJG.0b013e31818fb44e.

    Article  PubMed  Google Scholar 

  14. Broadway DC, Bloom PA, Bunce C, Thiagarajan M, Khaw PT. Needle revision of failing and failed trabeculectomy blebs with adjunctive 5-fluorouracil: survival analysis. Ophthalmology. 2004;111(4):665–73. doi:10.1016/j.ophtha.2003.07.009.

    Article  PubMed  Google Scholar 

  15. Freidl KB, Moster MR. ExPRESS shunt surgery: preferred glaucoma surgery in residency training? Surv Ophthalmol. 2012;57(4):372–5. doi:10.1016/j.survophthal.2012.02.008.

    Article  PubMed  Google Scholar 

  16. de Jong LA. The Ex-PRESS glaucoma shunt versus trabeculectomy in open-angle glaucoma: a prospective randomized study. Adv Ther. 2009;26(3):336–45. doi:10.1007/s12325-009-0017-6.

    Article  PubMed  Google Scholar 

  17. de Jong L, Lafuma A, Aguade AS, Berdeaux G. Five-year extension of a clinical trial comparing the EX-PRESS glaucoma filtration device and trabeculectomy in primary open-angle glaucoma. Clin Ophthalmol. 2011;5:527–33. doi:10.2147/OPTH.S18565.

    PubMed Central  PubMed  Google Scholar 

  18. Moisseiev E, Zunz E, Tzur R, Kurtz S, Shemesh G. Standard trabeculectomy and Ex-PRESS miniature glaucoma shunt: a comparative study and literature review. J Glaucoma. 2014. doi:10.1097/IJG.0000000000000047.

    Google Scholar 

  19. Wagschal LD, Trope GE, Jinapriya D, Jin YP, Buys YM. Prospective randomized study comparing Ex-PRESS to trabeculectomy: 1-year results. J Glaucoma. 2013. doi:10.1097/IJG.0000000000000029.

    Google Scholar 

  20. Cunliffe IA, Dapling RB, West J, Longstaff S. A prospective study examining the changes in factors that affect visual acuity following trabeculectomy. Eye (Lond). 1992;6(Pt 6):618–22. doi:10.1038/eye.1992.133.

    Article  Google Scholar 

  21. Good TJ, Kahook MY. Assessment of bleb morphologic features and postoperative outcomes after Ex-PRESS drainage device implantation versus trabeculectomy. Am J Ophthalmol. 2011;151(3):507–13. doi:10.1016/j.ajo.2010.09.004. e501.

    Article  PubMed  Google Scholar 

  22. Maris Jr PJ, Ishida K, Netland PA. Comparison of trabeculectomy with Ex-PRESS miniature glaucoma device implanted under scleral flap. J Glaucoma. 2007;16(1):14–9. doi:10.1097/01.ijg.0000243479.90403.cd.

    Article  PubMed  Google Scholar 

  23. Seider MI, Rofagha S, Lin SC, Stamper RL. Resident-performed Ex-PRESS shunt implantation versus trabeculectomy. J Glaucoma. 2012;21(7):469–74. doi:10.1097/IJG.0b013e3182182bfb.

    Article  PubMed  Google Scholar 

  24. Chen G, Li W, Jiang F, Mao S, Tong Y. Ex-PRESS implantation versus trabeculectomy in open-angle glaucoma: a meta-analysis of randomized controlled clinical trials. PLoS One. 2014;9(1):e86045. doi:10.1371/journal.pone.0086045.

    Article  PubMed Central  PubMed  Google Scholar 

  25. Carreno E, Villaron S, Portero A, Herreras JM, Maquet JA, Calonge M. Surgical outcomes of uveitic glaucoma. J ophthalmic inflamm infect. 2011;1(2):43–53. doi:10.1007/s12348-010-0012-8.

    Article  PubMed Central  PubMed  Google Scholar 

  26. Siddique SS, Suelves AM, Baheti U, Foster CS. Glaucoma and uveitis. Surv Ophthalmol. 2013;58(1):1–10. doi:10.1016/j.survophthal.2012.04.006.

    Article  PubMed  Google Scholar 

  27. Sung VC, Barton K. Management of inflammatory glaucomas. Curr Opin Ophthalmol. 2004;15(2):136–40.

    Article  PubMed  Google Scholar 

  28. Ceballos EM, Beck AD, Lynn MJ. Trabeculectomy with antiproliferative agents in uveitic glaucoma. J Glaucoma. 2002;11(3):189–96.

    Article  PubMed  Google Scholar 

  29. Kaburaki T, Koshino T, Kawashima H, Numaga J, Tomidokoro A, Shirato S, Araie M. Initial trabeculectomy with mitomycin C in eyes with uveitic glaucoma with inactive uveitis. Eye (Lond). 2009;23(7):1509–17. doi:10.1038/eye.2009.117-cme.

    Article  CAS  Google Scholar 

  30. Kok H, Barton K. Uveitic glaucoma. Ophthalmol Clin North Am. 2002;15(3):375–87. viii.

    Article  PubMed  Google Scholar 

  31. Moorthy RS, Mermoud A, Baerveldt G, Minckler DS, Lee PP, Rao NA. Glaucoma associated with uveitis. Surv Ophthalmol. 1997;41(5):361–94.

    Article  CAS  PubMed  Google Scholar 

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Compliance with Ethical Requirements

Dr. Allen had no conflict of interest. Dr. Sarkisian is a consultant to Alcon. All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all patients for being included in the study.

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Authors and Affiliations

  1. Dean McGee Eye Institute, Oklahoma City, OK, USA

    Evan Allan M.D. & Steven R. Sarkisian Jr. M.D.

Authors
  1. Evan Allan M.D.
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  2. Steven R. Sarkisian Jr. M.D.
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Corresponding author

Correspondence to Evan Allan M.D. .

Editor information

Editors and Affiliations

  1. Illinois Eye & Ear Infirmary, University of Illinois at Chicago School of Medicine, Chicago, Illinois, USA

    Ahmad A. Aref

  2. Southern California, LA, CA, USA, USC Eye Ins.Dept. of Ophth. Univ.of Southern California, LA, CA, USA, California, California, USA

    Rohit Varma

9.1 Electronic Supplementary Material

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Ex-PRESS Shunt Implantation; Steven R. Sarkisian, Jr., MD (MV4 204,075 kb)

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© 2015 Springer International Publishing Switzerland

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Allan, E., Sarkisian, S.R. (2015). Ex-PRESS Miniature Glaucoma Shunt for the Treatment of Uveitic Glaucomas. In: Aref, A., Varma, R. (eds) Advanced Glaucoma Surgery. Essentials in Ophthalmology. Springer, Cham. https://doi.org/10.1007/978-3-319-18060-1_9

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  • DOI: https://doi.org/10.1007/978-3-319-18060-1_9

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-18059-5

  • Online ISBN: 978-3-319-18060-1

  • eBook Packages: MedicineMedicine (R0)

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