Resident-performed Ex-PRESS shunt implantation versus trabeculectomy.


Journal Article

PURPOSE: To compare outcomes between resident-performed trabeculectomy and Ex-PRESS shunt implantation. METHODS: A consecutive cohort of 36 Ex-PRESS shunt implantations and 57 trabeculectomies (1 eye/patient) performed by resident surgeons in their third year of ophthalmic training at the University of California, San Francisco and at the San Francisco Veterans Administration Hospital, under the supervision of a single glaucoma fellowship-trained surgeon were included in this study. Eyes with < 6 months of follow-up or previous glaucoma surgery were excluded. Preoperative and postoperative intraocular pressure (IOP), preoperative and postoperative number of ocular antihypertensive medications and complication rates were compared between the 2 procedures retrospectively. RESULTS: No difference was found in postoperative IOP (all, P≥0.099) or proportional decrease in IOP (all, P≥0.092) between the trabeculectomy and Ex-PRESS shunt groups at all follow-up points. On average, the Ex-PRESS shunt group required significantly less ocular antihypertensive medication to control IOP at 3 months postoperative (P=0.01), but no difference was found at 6 months or 1 year (all, P≥0.28). A larger proportion of Ex-PRESS shunt patients had good IOP control without medication at 3 (P=0.057) and 6 months (P=0.076) postoperatively. No difference was found in the rates of sight-threatening complications between groups (all, P≥0.22). CONCLUSIONS: In the hands of ophthalmology residents in their third year of training, the trabeculectomy and Ex-PRESS shunt implantation procedures perform comparably in terms of postoperative IOP control, reduction in patient dependence on ocular antihypertensive medications, and risk of complication in our population.

Full Text

Cited Authors

  • Seider, MI; Rofagha, S; Lin, SC; Stamper, RL

Published Date

  • September 2012

Published In

Volume / Issue

  • 21 / 7

Start / End Page

  • 469 - 474

PubMed ID

  • 21522022

Pubmed Central ID

  • 21522022

Electronic International Standard Serial Number (EISSN)

  • 1536-481X

Digital Object Identifier (DOI)

  • 10.1097/IJG.0b013e3182182bfb


  • eng

Conference Location

  • United States