COMPARISON BETWEEN EX-PRESS MINI SHUNT IMPLANTATION AND DEEP SCLEROTOMY IN PATIENTS WITH PRIMARY OPEN-ANGLE GLAUCOMA (POAG)

Purpose: is to compare the success rate of Ex-PRESS implantation vs deep sclerotomy (DS) in patients with primary open-angle glaucoma (POAG). Patients and methods: This is a randomized prospective interventional comparative study between Ex-PRESS and DS maneuvers in patients with POAG. The study included 47patients (50 eyes) with POAG. The patients were divided into two groups. Group 1 included 25 patients (25 eyes) who underwent Ex-PRESS device implantation. Group 2 included 22 patients (25 eyes) who underwent DS. All included patients underwent a thorough ophthalmic examination. At the end of the 1 st year postoperatively, best corrected visual acuity (BCVA) [logMAR], intraocular pressure (IOP), number of anti-glaucoma medications in use were obtained. Results: In group 1, complete success rate was 76%, qualified success rate was 20% and failure rate 4% occurred in 1 eye of patients which needed explantation of the device and another glaucoma filtering surgery due to device-corneal touch. Meanwhile in group 2, complete success rate was36% and qualified success rate was 64% without any recorded failure in this group (Both Ps<0.01) in both groups. Conclusion: favorable effects on IOP and the need for IOPlowering medications in both Ex-PRESS and DS groups. However, in DS group, higher preoperative IOP is associated with increased failure rate necessitating more postoperative IOP adjustments than Ex-PRESS group.