Original StudiesComparison of Trabeculectomy With Ex-PRESS Miniature Glaucoma Device Implanted Under Scleral FlapMaris, Peter J. G. Jr MD; Ishida, Kyoko MD; Netland, Peter A. MD, PhDAuthor Information Hamilton Eye Institute, University of Tennessee Health Sciences Center, Memphis, TN Reprints: Peter A. Netland, MD, PhD, Hamilton Eye Institute, University of Tennessee Health Science Center, 930 Madison Avenue, Suite 100, Memphis, TN 38163 (e-mail: [email protected]). Received for publication February 27, 2006; accepted September 29, 2006 Presented in part at the Annual Meeting of the American Academy of Ophthalmology, Chicago, IL, October 17, 2005. The authors have no proprietary interests in any of the materials described in this manuscript. Journal of Glaucoma: January 2007 - Volume 16 - Issue 1 - p 14-19 doi: 10.1097/01.ijg.0000243479.90403.cd Buy Metrics Abstract Purpose To evaluate the Ex-PRESS miniature implant (Model R 50) placed under partial-thickness scleral flap compared with standard trabeculectomy. Methods In this retrospective comparative series of 100 eyes, we compared 50 eyes in 49 patients treated with the Ex-PRESS miniature glaucoma implant under a scleral flap with 50 matched control eyes in 47 patients treated with trabeculectomy. Success was defined as intraocular pressure (IOP) ≥5 mm Hg and ≤21 mm Hg, with or without glaucoma medications, without further glaucoma surgery or removal of implant. Early postoperative hypotony was defined as IOP <5 mm Hg during the first postoperative week. Results The average follow-up was 10.8 months (range 3.5 to 18) for the Ex-PRESS group and 11.2 months (range 3 to 15) for the trabeculectomy group. Although the mean IOP was significantly higher in the early postoperative period in the Ex-PRESS group compared with the trabeculectomy group, the reduction of IOP was similar in both groups after 3 months. The number of postoperative glaucoma medications in both groups was not significantly different. Kaplan-Meier survival curve analysis showed no significant difference in success between the 2 groups (P=0.594). Early postoperative hypotony and choroidal effusion were significantly more frequent after trabeculectomy compared with Ex-PRESS implant under scleral flap (P<0.001). Conclusions The Ex-PRESS implant under a scleral flap had similar IOP-lowering efficacy with a lower rate of early hypotony compared with trabeculectomy. © 2007 Lippincott Williams & Wilkins, Inc.