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Minimally Invasive External Mini-Glaucoma Shunt Implantation Without Conjunctival Dissection

Hoffman, Richard S. MD*; Crandall, Alan S. MD; Crandall, David A. MD; Fine, I. Howard MD*; Packer, Mark MD*; Sims, Annette C. MD*

doi: 10.1097/IJG.0b013e31826a7edf
Case Report

The current method for implantation of the Ex-PRESS Glaucoma Filtration Device requires a conjunctival peritomy and shunt insertion under the guarded protection of a scleral flap. This technique requires suture closure of the flap and conjunctiva. A new minimally invasive technique for Ex-PRESS shunt implantation allows for insertion through a scleral tunnel originating from a grooved clear corneal incision. This new method avoids the need for conjunctival dissection and closure and offers the advantages of eliminating conjunctival wound leaks while maintaining the protection of a partial thickness scleral covering. This new technique may offer a faster safer means for shunt implantation with the potential for less conjunctival scarring.

*Drs Fine Hoffman & Packer LLC, Eugene, OR

John A. Moran Eye Center, University of Utah, Salt Lake City, UT

Henry Ford Health System, Detroit, MI

Disclosure: Dr A.S.C. is a consultant for Alcon Laboratories. The remaining authors declare no conflict of interest.

Reprints: Richard S. Hoffman, MD, 1550 Oak Street, Suite 5, Eugene, OR 97401 (e-mail:

Received January 23, 2012

Accepted June 5, 2012

© 2014 by Lippincott Williams & Wilkins.