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Factors influencing the filtration-bleb volume after Ex-PRESS® surgery

Authors Tojo N, Hayashi A, Otsuka M

Received 26 April 2018

Accepted for publication 22 June 2018

Published 5 September 2018 Volume 2018:12 Pages 1675—1683

DOI https://doi.org/10.2147/OPTH.S172400

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 2

Editor who approved publication: Dr Scott Fraser


Naoki Tojo, Atsushi Hayashi, Mitsuya Otsuka

Department of Ophthalmology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Japan

Purpose: The aim of this study was to investigate the factors influencing the volume of the filtration bleb after Ex-PRESS® surgery.
Methods: This was a retrospective non-randomized study. After excluding patients who had undergone an additional glaucoma surgery, 99 glaucoma patients who underwent Ex-PRESS® surgeries and were followed up for >2 years were analyzed. We used anterior segment optical coherence tomography to measure the bleb volume, and compared the volume at 1 year with that at 2 years after surgery. We also examined potential influencing factors, including age, number of medications, central corneal thickness, type of glaucoma, preoperative intraocular pressure (IOP), postoperative IOP, reduction ratio of IOP, history of trabeculotomy, and operation method (Ex-PRESS® surgery only or simultaneous cataract surgery).
Results: Ex-PRESS® surgeries significantly decreased the IOP from 26.3±9.7 mmHg to 11.6±3.7 mmHg after 24 months (P<0.001). The success rate at 2 years was 81.2% (IOP ≥21 mmHg or ≥20% reduction from the baseline IOP). The results showed that age, postoperative IOP, glaucoma type, and simultaneous cataract surgeries influenced the filtration-bleb volume.
Conclusion: Advanced age, higher postoperative IOP, pseudo-exfoliation glaucoma, and simultaneous cataract surgeries were all found to decrease the volume of the filtration bleb.

Keywords: Ex-PRESS, glaucoma, bleb, size, factors, volume

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