Trabeculectomy with Ologen implant versus trabeculectomy with P 50 Ex-PRESS shunt in primary open-angle glaucoma

BackgroundThis is the first randomized controlled trial of trabeculectomy with Ex-Press Shunt versus Ologen implant in primary open-angle glaucoma (POAG) in Indian eyes.MethodsA prospective randomized controlled trial of patients of POAG treated with two different methods of augmented trabeculectomy. Group A with Ex-PRESS shunt (P50 model) and Group B with Ologen implant. Surgical success was defined as intraocular pressure of 21 mm Hg or lower at 6 months postoperative.ResultsN = 40 eyes of 33 patients. Baseline IOP in Group A was 23.70 ± 4.6 mm Hg (Range 22–36 mm Hg), and Group B was 26.00 ± 4.0 mm Hg (Range 23–36 mm Hg). Surgical success was achieved in 85% of patients in both Groups. Change in IOP from baseline was statistically significant in both groups at 1, 4, 8, 12 weeks, and 6 months postoperative. No statistically significant difference in the change in IOP between the two groups. Postoperative complications were lesser in Group A compared to Group B, in both early (35% vs 50%) and late stage (20% vs 30%). The drop in visual acuity became statistically insignificant at 4 weeks in Group A and 8 weeks in Group B.ConclusionsThere is no difference between the surgical success rates of trabeculectomy with Ex-PRESS Shunt versus Ologen. However, the Ex-PRESS shunt fares better with lower complication rates and faster visual recovery than the Ologen group.     

青光眼小梁切除术中应用丝裂霉素和甲基纖维素对比观察

目的 為了探討提高青光眼小梁切除術成功率及减少并發症的新方法。方法 小梁切除衍中應用甲基纖維素(MC)和絲裂毒素(MMC),設A、B兩組做對照,觀察術后并發症及成功率。結果 術后低眼壓在MMC組發生率48.08％,在MC組發生率7.69％,兩組有非常顯著性差异P<0.01.術后3個月眼壓控制情况MMC組88.46％,MC組92.31％,經統計學處理P>0.05無顥著性差异。術后淺前房發生率MMC組78.85％,MC組11.54％。兩組有非常顯著性差异(P<0.01)。結論 在青光眼小梁切除術中應用MC優于MMC。