Our Summary

The research paper is a comparison of two surgical methods, Ex-PRESS® surgery (EXP) and trabeculectomy (Trab), for treating primary open-angle glaucoma (POAG), a common type of glaucoma, in patients with low preoperative intraocular pressure (IOP). The study found that both surgical procedures significantly decreased intraocular pressure (IOP). However, trabeculectomy was able to decrease IOP more than Ex-PRESS surgery but may have more complications. The study did not find any significant difference in the number of postoperative medications needed, the success rate, the decrease in corneal endothelial cell density, or the difference in visual acuity between the two surgical methods. The research was based on a retrospective non-randomized study of POAG patients who had undergone either of the two surgical procedures and were followed up for more than 2 years.

FAQs

  1. What are the two surgical methods compared in the research paper for treating primary open-angle glaucoma?
  2. Which surgical procedure was found to decrease intraocular pressure more effectively?
  3. Was there any significant difference found in the success rate, postoperative medications needed, or visual acuity between Ex-PRESS surgery and trabeculectomy?

Doctor’s Tip

A helpful tip a doctor might give a patient about glaucoma surgery is to follow the post-operative care instructions carefully, including taking any prescribed medications as directed, attending follow-up appointments, and avoiding activities that may increase eye pressure, such as heavy lifting or straining. It is also important to report any unusual symptoms or changes in vision to your doctor immediately. Following these guidelines can help ensure a successful outcome and minimize the risk of complications.

Suitable For

Patients who are typically recommended glaucoma surgery are those who have been diagnosed with primary open-angle glaucoma (POAG) and have not been able to adequately manage their intraocular pressure (IOP) with medication or other non-surgical treatments. In the case of this study, patients with low preoperative IOP were specifically chosen to compare the effectiveness of Ex-PRESS surgery and trabeculectomy in lowering IOP.

It is important for patients to discuss the potential benefits and risks of glaucoma surgery with their ophthalmologist, as the decision to undergo surgery should be based on individual factors such as the severity of the glaucoma, the patient’s overall health, and their willingness to undergo surgery and follow postoperative care instructions.

Timeline

Before glaucoma surgery, a patient may experience symptoms such as blurry vision, eye pain, nausea, vomiting, and halos around lights. They may also undergo various diagnostic tests such as visual field testing, intraocular pressure measurement, and optic nerve imaging to determine the severity of their condition.

After glaucoma surgery, a patient may experience temporary blurred vision, redness, swelling, and discomfort in the eye. They will be prescribed eye drops to prevent infection and reduce inflammation. Follow-up appointments will be scheduled to monitor the healing process and ensure that the surgery was successful in reducing intraocular pressure.

Over time, the patient will gradually experience improved vision and reduced symptoms of glaucoma. They may still need to continue using eye drops or other medications to manage their condition and prevent further damage to the optic nerve. Regular eye exams will be necessary to monitor the progression of glaucoma and adjust treatment as needed.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with glaucoma surgery, specifically Ex-PRESS surgery and trabeculectomy?

  2. How long is the recovery period after glaucoma surgery, and what can I expect during the recovery process?

  3. How effective is glaucoma surgery in lowering intraocular pressure, and what are the success rates for Ex-PRESS surgery compared to trabeculectomy?

  4. Will I need to continue using eye drops or other medications after undergoing glaucoma surgery?

  5. How will glaucoma surgery affect my vision, and are there any potential side effects or changes in visual acuity that I should be aware of?

  6. What is the long-term prognosis for my glaucoma after undergoing surgery, and will I need additional procedures in the future?

  7. Can you explain the differences between Ex-PRESS surgery and trabeculectomy in terms of the surgical technique, recovery time, and potential outcomes?

  8. Are there any specific factors or characteristics of my glaucoma that make me a better candidate for one type of surgery over the other?

  9. How often will I need to follow up with my eye doctor after glaucoma surgery, and what will be involved in these follow-up appointments?

  10. Are there any alternative treatment options or non-surgical approaches that I should consider before deciding on glaucoma surgery?

Reference

Authors: Otsuka M, Hayashi A, Tojo N. Journal: Int Ophthalmol. 2022 Nov;42(11):3367-3375. doi: 10.1007/s10792-022-02335-0. Epub 2022 May 10. PMID: 35538255