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Corneal ectatic disorders, such as keratoconus, progressively weaken corneal integrity, leading to thinning, irregular astigmatism and visual deterioration.1 Typically progressive in nature, these ectasias result in increasingly thinner corneas, causing the cornea to protrude forward into a cone shape. This leads to increasing amounts of myopia and astigmatism – both regular and irregular – as the disease […]

The Evolution in Glaucoma Surgery – Latest Advances in Filtration Surgery

Katrina Mountfort
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Published Online: Jan 23rd 2013 European Ophthalmic Review, 2012;6(5):269-274 DOI: http://doi.org/10.17925/EOR.2012.06.05.269
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Article

Abstract

In recent years, an increased understanding of intraocular pressure (IOP) has facilitated advances in surgical techniques in the treatment of glaucoma. Although trabeculectomy has been the gold standard of glaucoma surgery for over four decades, new devices have recently

Abstract

In recent years, an increased understanding of intraocular pressure (IOP) has facilitated advances in surgical techniques in the treatment of glaucoma. Although trabeculectomy has been the gold standard of glaucoma surgery for over four decades, new devices have recently
been introduced, including the EX-PRESS™ glaucoma filtration device (GFD). An important requirement of any surgical or medical procedure to lower IOP is effectiveness over a 24-hour period, since IOP is at its highest at night. Recent data have demonstrated that the EX-PRESS™ GFD can achieve a similar reduction in IOP to that achieved by trabeculectomy, but with a significantly reduced rate of complications. Following the successful learning of a number of surgical techniques, most of which are currently mastered by the skilled trabeculectomy surgeon, implantation of the Ex-PRESS TM GFD is no more challenging than a traditional trabeculectomy and provides rapid post-operative recovery. Since cost considerations prohibit the use of the EX-PRESS™ GFD in all cases of glaucoma surgery, patient selection is important. It must be stressed, however, that use of the EX-PRESS™ GFD results in reduced indirect costs as a result of its better predictability, shorter operative time and reduced short-term post-operative complications.

Support: The publication of this article was funded by Alcon. The views and opinions expressed are those of the author and not necessarily those of Alcon.

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