Effect of Ex-PRESS glaucoma filtration device on corneal endothelium in primary open-angle glaucoma

• Main Authors: Dina Abd El Fattah Abd El Rehim, Abd-Almonem Abo-Alfotouh El-Hessy, Sherif El-Saeed El-Kholy, Ehab Hassan Nematalla, Eglal Mohamed El-Saeed
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2019-01-01
• Series: Journal of the Egyptian Ophthalmological Society
• Subjects: Ex-PRESS; glaucoma; intraocular pressure; trabeculectomy
• Online Access: http://www.jeos.eg.net/article.asp?issn=2090-0686;year=2019;volume=112;issue=1;spage=9;epage=13;aulast=El

Purpose The aim of this study is to compare the effect of Ex-PRESS minishunt versus standard trabeculectomy on corneal endothelial cell count (ECC) in cases of primary open-angle glaucoma. Setting This comparative prospective nonrandomized study was conducted at Mansoura Ophthalmic Center, Mansoura University, Mansoura, Egypt. Patients and methods The study included 36 eyes of 25 patients with uncontrolled primary open-angle glaucoma. Nineteen eyes had Ex-PRESS glaucoma minishunt and 17 eyes had trabeculectomy. Specular microscopy was used to measure ECC using TOMEY EM-3000. ECC was measured preoperatively and compared with postoperative values at 6 and 12 months. Results The mean endothelial cell density was 2493.2±246.8 cells/mm2 before the surgery in the Ex-PRESS group and 2473.8±259.8 cells/mm2 in the trabeculectomy group (P=0.82). This value decreased significantly in both groups at 12 months postoperatively to 2348.1±309.5 in the Ex-PRESS group and 2276.1±342.4 in the trabeculectomy group. ECC loss at 1 year was less in the Ex-PRESS group at 5.7 versus 8% in the trabeculectomy group (P=0.051). Conclusion Ex-PRESS minishunt is considered a safe procedure regarding corneal endothelium, showing less decrease in ECC than conventional trabeculectomy.