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Glaucoma shunt compares favorably with trabeculectomy at 1 year
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SAN FRANCISCO — A glaucoma shunt and trabeculectomy yielded largely similar outcomes, although the shunt offered faster visual recovery, a speaker told colleagues here.
“There are some potential advantages of Ex-Press. Specifically, for people who are comfortable doing a trabeculectomy, it’s a very short learning curve,” Yvonne M. Buys, MD, FRCSC, said at the American Glaucoma Society annual meeting.
Buys and colleagues conducted a 1-year prospective randomized controlled trial comparing the Ex-Press shunt (Alcon) to trabeculectomy. The trial included 33 patients with uncontrolled open-angle glaucoma who underwent Ex-Press implantation and 31 patients who underwent trabeculectomy. Thirty patients in the trabeculectomy group and 31 patients in the Ex-Press group completed 1-year follow-up.
Yvonne M. Buys
Study results showed that IOP and the number of glaucoma medications decreased significantly in both groups. Both groups had similar rates of qualified and complete surgical success, Buys said.
One intraoperative complication in the Ex-Press group required conversion to trabeculectomy, she said. Both groups had similar postoperative complication rates.
Buys said that visual acuity decreased in both groups; however, patients in the Ex-Press group may have recovered vision more rapidly than those in the trabeculectomy group.
“If you have a patient who would be applicable to either Ex-Press or trabeculectomy, I think you’d like to consider a number of metrics in making the decision of which procedure to proceed with,” Buys said.
One drawback is the increased cost of the Ex-Press shunt, which totaled $956 per case, she said.
Disclosure: Buys has received speaking honoraria from Alcon.