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

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.

1. Egorov E.A., ed. Glaucoma. National guidelines. Moscow: GEOTAR-Media. 2013: 684–5 (in Russian)

2. EGS-European Glaucoma Society. Terminology and guidelines for glaucoma (4th edition). Publicomm srl; 2014: 170–2.

3. Anisimova S.Yu., Anisimov S.I., Rogacheva I.V. Long-term results of surgical treatment of refractory glaucoma using collagen drainage resistant to biodegradation. Glaucoma. 2011; 2: 28–33 (in Russian)

4. Slonimskij А., Alekseev I., Dolgij S., Korigodskij А. New biodegraded drainage Glautex in the surgical treatment of glaucoma. Natsional’nyi zhurnal glaukoma. 2012; 12 (4): 55–9 (in Russian)

5. Slonimskiy A.Y., Alekseev I.B., Dolgiy S.S. New possibilities of excessive postoperative scarring prophylaxis by glaucoma surgery. Oftal'mologiya. 2012; 9 (3): 36–40 (in Russian). https://doi.org/10.18008/1816-50952012-3-36-40

6. Alekseev I.B., Abrosimova E.V., Adleiba O., et al. The Russian experience of glaucoma surgery using Glautex implant. Klinicheskaya oftal’mologija. 2014; 4: 193–7 (in Russian)

7. Salim S. The role of the Ex-PRESS glaucoma filtration device in glaucoma surgery. Semin. Ophthalmol. 2013; 28 (3 May): 180–4. doi: 10.3109/08820538.2013.771197

8. Erichev V.P., Asratyan G.K. Mini-shunt glaucoma surgery. Natsional’nyi zhurnal glaukoma. 2012; 11 (2): 66–9 (in Russian)

9. Avetisov S.E., Erichev V.P., Asratyan G.K., Аvetisov К, Kobzova М. Microshunt procedures in glaucoma surgery in artiphakic eyes. Natsional’nyi zhurnal glaukoma. 2013; 12 (3): 44–7 (in Russian)

10. Kuroedov A.V., Ogorodnikova V.Yu. Micro drainage using of Ex-PRESS mini-shunt as an option of surgical treatment of the patients with primary open angle glaucoma in advanced stages of the disease. Oftal'mologiya. 2010; 7 (1): 23–8 (in Russian)