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IOP may be lowered significantly with glaucoma implant after modified deep sclerectomy

Eur J Ophthalmol. 2011;21(1):12-19.

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Insertion of a glaucoma implant into the anterior chamber after modified deep sclerectomy in combined glaucoma and cataract surgery may effectively lower IOP, a study showed.

The prospective, nonrandomized study consisted of 24 eyes with uncontrolled glaucoma that were implanted with the Ex-PRESS LR-50 (Optonol). A bleb was created through a partial posterior deep sclerectomy, and the device was then implanted into the anterior chamber under a scleral flap.

Mean IOP had decreased by 25.4% at 24 months postop and 27% at 48 months postop. Mean best corrected visual acuity was 0.6 ±0.3 preoperatively. At 24 months, 86.3% of patients had achieved a BCVA of 0.5 or better. However, the mean BCVA was 0.7 ±0.3 at 48 months, which the study authors attributed to unrelated disease.

The mean number of medications decreased from 2.3 ±1.1 preop to 0.6 ±0.8 at last follow-up. No conjunctival erosions occurred.

Implantation of the Ex-PRESS LR-50 under a scleral flap, which marks a deviation from the earlier subconjunctival technique, prevents erosion of the conjunctiva and tube dislocation, the study authors wrote.