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

Purpose: To compare the postoperative interventions and outcomes between conventional trabeculectomy and trabeculectomy with the Ex-PRESS® mini-glaucoma shunt device (Ex-Press). Methods: This was a retrospective, comparative, single-facility study. We analyzed the cases of 108 glaucoma patients who underwent trabeculectomy and were followed for >1 year. Thirty-nine eyes underwent a conventional trabeculectomy (conventional group) and 69 eyes underwent a trabeculectomy with an Ex-Press (Ex-Press group). As evaluation items, we examined postoperative intraocular pressure (IOP), the surgical success rate, postoperative complications, the number of days to laser suture lysis, and needling. Results: Trabeculectomy significantly decreased the patients’ IOP values from 27.8±7.9 to 11.1±3.9 mmHg in the conventional group (p<0.001) and from 27.7±9.2 to 11.5±3.7 mmHg in the Ex-Press group (p<0.001) after 1 year. The success rate was not significantly different between the groups. The timing of the first laser suture lysis was significantly sooner in the Ex-Press group, and the Ex-Press group showed significantly less choroidal detachment due to low IOP. Conclusion: Earlier laser suture lysis in patients whose trabeculectomy treatment includes an Ex-Press is required to obtain the outcomes comparable to those of conventional trabeculectomy.