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Clinician reviews pros, cons of glaucoma filtration device
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COPENHAGEN, Denmark — A filtration device has features that make it an attractive alternative to trabeculectomy, but questions remain regarding its impact on endothelial cell loss, a clinician said here.
Tarek Shaarawy, MD, MSc, spoke about the Ex-PRESS glaucoma filtration device (Alcon) at the Educational Partner Lunchtime Symposium with Alcon at the European Glaucoma Society meeting.
“In terms of advantages, it [has] a standardized flow,” he said. “And from what we can see in the literature, there is a potential for better predictability. It comes with a shorter operative time, and that is always appreciated if you have … the highest number of operations allocated in your surgical time.”
It also appears to have a shorter learning curve compared with trabeculectomy and fewer short-term postoperative complications, Shaarawy said.
However, the device has “issues that we have to manage and handle,” Shaarawy said.
“[For instance,] the effect of putting this device into the anterior chamber and its effect on endothelial cells,” he said. “Our group in Geneva has published, in the last couple of years, some work on endothelial cell loss after tubes, and that seems to be significant. It remains to be seen how an Ex-PRESS will compare to a trabeculectomy and how it will compare to a tube. That’s precisely what we are doing in Geneva now, and I am hoping that in a couple of months we can present preliminary data on the loss of endothelial cells in a trabeculectomy, in an Ex-PRESS and compare that to tubes.”
- Disclosure: Shaarawy has no relevant financial disclosures.