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Middle East African Journal of Ophthalmology Middle East African Journal of Ophthalmology
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Year : 2016  |  Volume : 23  |  Issue : 2  |  Page : 177-182

Trabeculectomy versus ex-press glaucoma filtration device in silicomacrophagocytic open angle glaucoma secondary to silicone oil emulsification

1 Ophthalmology Unit, Azienda Ospedaliera "Cardinale G. Panico", Lecce, Italy
2 Department of Ophthalmology, Ospedale Pediatrico Bambino Gesł, Rome, Italy

Correspondence Address:
Donato Errico
Ophthalmology Unit, Glaucoma Service, Azienda Ospedaliera Cardinale G. Panico, Via San Pio X 4, Tricase 73039, Lecce
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0974-9233.175889

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Purpose: To compare the outcomes of Ex-PRESS device implantation versus trabeculectomy in patients with ocular hypertension after pars plana vitrectomy and silicone oil injection (SOI). Materials and Methods: Twenty-six consecutive eyes with ocular hypertension after pars plana vitrectomy and SOI were included in this study and randomized to one of two groups: A group treated with Ex-PRESS (model P50) placed under a scleral flap (Ex-PRESS group), and a group treated with trabeculectomy (trabeculectomy group). Complete success (intraocular pressure [IOP] <21 mmHg without medication) and qualified success rates (IOP <21 mmHg with one or two glaucoma medications) at 2 years postoperatively were analyzed. Between-groups comparison was performed with the Mann-Whitney U-test for continuous variables, and Fischer exact test for categorical data. Success rates between groups were compared using Kaplan-Meier life analysis and the log-rank test. P < 0.05 was considered statistically significant. Results: In the Ex-PRESS group, complete success was achieved in 73% eyes and qualified success in 81.8% of eyes. In the trabeculectomy group, complete success was achieved in 40% and qualified success was achieved in 60% of eyes. The difference in mean IOP between groups was statistically significant from the 3 rd postoperative month onward (P = 0.007 at 3 months, P = 0.003 at 6 months, and P = 0.03 at 24 months). Conclusion: Ex-PRESS implantation was more effective than trabeculectomy in controlling IOP in ocular hypertensives after pars plana vitrectomy and SOI, but the surgical technique may require improvement.

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