Using of modern types of drainage in glaucoma surgery: our experience

Abstract

Purpose. To evaluate antihypertensive efficiency and safeness of Xenoplast, Glautex, and Ex-PRESS drainage during glaucoma surgery. Material and methods. 249 patients with primary open angle glaucoma (253 eyes) underwent antihypertensive operations with Xenoplast (group I, 121 patients aged 68.6 ± 7.7 yrs), Glautex (group II, 49 patients aged 66.8 ± 7.7 yrs) and Ex-PRESS (group III, 79 patients aged 67.9 ± 8.3 yrs). In groups I and II, drainages were implanted during penetrating and non-penetrating surgery. Long-term results were traced for 2 years. Results. In the early postoperative period, all groups had complications typical for antiglaucoma surgery without drainage: I — 14.8 %, II — 16.8 %, III — 16.8 %. An absolute success of the operation (normalization of IOP without additional antihypertensive therapy) was achieved as follows. In group I for patients with non-penetrating deep sclerectomy it was achieved in 98.4 % of cases at the moment of discharge from hospital, whereupon the figure fell to 15.4 % in 18 months. In group I patients, with trabeculectomy the success was achieved in 96.7 %, dropping to 6.7 %. In group II for patients with non-penetrating deep sclerectomy the success claimed 96.3 %, but after 12 months it vanished completely. In group II with trabeculectomy the success reached 95.7 %, but dropped to 16.7 % after 24 months. In group III the success rate at the moment of discharge was 96.3 % but it dropped to 16.7 % after 24 months. In cases if target pressure could not be achieved the surgery was repeated. Conclusion. The absolute success originally achieved in all groups (96.3–98.4 %) was not persistent and after a 2-year observation, tended to disappear. The effect lasted longer in eyes after trabeculectomy with Glautex and Ex-PRESS. The hypotensive effect of primary antiglaucoma surgery was higher in penetrating operations.