scholarly journals The first report on intermediate-term outcome of Ex-PRESS® glaucoma filtration device implanted under scleral flap in Japanese patients

2011 ◽  
pp. 1063 ◽  
Author(s):  
Tetsuya Sugiyama ◽  
Maho Shibata ◽  
Shota Kojima ◽  
Mari Ueki ◽  
Tsunehiko Ikeda
Keyword(s):  
Japanese Patients ◽  
Scleral Flap ◽  
Term Outcome ◽  
First Report ◽  
Glaucoma Filtration Device ◽  
Filtration Device

Complications Specific To Ex-Press™ Shunts

2013 ◽  
Author(s):  
Steven R. Jr. Sarkisian ,
Keyword(s):  
Kansas City ◽  
The United States ◽  
External Diameter ◽  
Fort Worth ◽  
Filtration Surgery ◽  
Scleral Flap ◽  
Laser Trabeculoplasty ◽  
Topical Medications ◽  
Glaucoma Filtration Device ◽  
Filtration Device

The EX-PRESS™ Glaucoma Filtration Device (Alcon Laboratories, Inc., Fort Worth, Texas) has been commercially available in the United States since 2002 and was originally developed by Optonol, Inc. (Kansas City, Kansas) for implantation directly under the conjunctiva for an indication of control of intraocular pressure (IOP). It is a nonvalved, stainless steel device almost 3 mm long with an external diameter of approximately 400 microns and a 50 or 200 micron lumen, depending on the model. It has an external disc at one end and a spur-like extension on the other to prevent extrusion. The EX-PRESS™ shunt is one option for controlling IOP available to today’s glaucoma surgeon. The challenges and complications involved with EX-PRESS™ shunts are addressed below, as well as how to manage and prevent such scenarios. The original unguarded technique of implantation under the conjunctiva resulted in numerous complications, including hypotony, extrusion, and, most commonly, erosion of the implant. Typically, there was a period of hypotony followed by failure and erosion of the implant. Endophthalmitis has also been associated with an exposed implant. To avoid complications associated with subconjunctival implantation, Dahan and Carmichael proposed implanting the device under a scleral flap. This technique has greatly reduced erosions, and EX-PRESS™ shunts have been reported to have a lower rate of hypotony than trabeculectomy (15.8% with EX-PRESS™ shunt versus 22.5% in trabeculectomy). Since 2003, the manufacturer has recommended all users only implant the device under a scleral flap. Like all filtration surgery, failure is most commonly from episcleral and subconjunctival fibrosis. As with traditional filtration surgery, intraoperative adjunctive antimetabolites, such as mitomycin-C, may be used to limit the degree of postoperative scarring. However, should failure due to fibrosis occur, there are several options. The first is to add topical medications or perform laser trabeculoplasty. The second is to perform bleb revision or needling with an antifibrotic agent. Finally, as in a failed trabeculectomy, the surgeon may abandon the EX-PRESS™ shunt and perform a second unrelated procedure.

Advances in the Surgical Management of Glaucoma – The Role of the EX-PRESS® Glaucoma Filtration Device

2012 ◽  
Vol 06 (02) ◽  
pp. 83
Author(s):  
Robert Fechtner ◽  
Leo de Jong ◽  
Elie Dahan ◽  
Malik Kahook ◽  
Marlene Moster ◽  
...  
Keyword(s):  
Surgical Techniques ◽  
Glaucoma Surgery ◽  
Filtration Surgery ◽  
Medical Laser ◽  
Scleral Flap ◽  
New Evidence ◽  
Fine Tune ◽  
Glaucoma Filtration Device ◽  
Filtration Device

Clinicians aim to arrest the glaucomatous process by reducing intraocular pressure (IOP).1–5Available strategies include medical, laser and surgical techniques. Trabeculectomy is the traditional standard drainage surgery technique to achieve this. These MIGS techniques therefore appear to be adequate for patients whose glaucomatous damage is mild to moderate and whose target IOPs fall into this range. To achieve lower IOPs in patients with more advanced visual loss, efforts have simultaneously been made to fine-tune trabeculectomy. The use of the EX-PRESS® Glaucoma Filtration Device (Alcon) under a scleral flap is one such approach. How does the EX-PRESS Glaucoma Filtration Device benefit the conventional trabeculectomy procedure? What tips and tricks can contribute to its successful use? How safe is it? Is the additional cost to our health system justifiable? The satellite symposium ‘Advances in glaucoma surgery: new evidence in filtration surgery’, held at the 2011 World Glaucoma Congress, chaired by Dr Ivan Goldberg and sponsored by Alcon, set out to try to answer these questions.

scholarly journals EX-PRESS Glaucoma Filtration Device: Management of Complications

Vision ◽  
2020 ◽  
Vol 4 (3) ◽  
pp. 39
Author(s):  
Michele Nicolai ◽  
Alessandro Franceschi ◽  
Paolo Pelliccioni ◽  
Vittorio Pirani ◽  
Cesare Mariotti
Keyword(s):  
Surgical Procedure ◽  
Refractory Glaucoma ◽  
Filtration Surgery ◽  
Device Management ◽  
Randomized Studies ◽  
Management Of Complications ◽  
Specific Device ◽  
Outflow Pathway ◽  
Glaucoma Filtration Device ◽  
Filtration Device

The EX-PRESS glaucoma filtration device appears to be an effective addition to our options to treat refractory glaucoma. The possibility to create a sclerostomy without tissue excision provides a safe and reliable outflow pathway for aqueous that is standard in size, reducing much of the variability associated with a surgical procedure. Prospective randomized studies comparing EX-PRESS implantation with trabeculectomy show encouraging results. However, complications usually encountered in filtration surgery have been reported, and EX-PRESS implantation can also lead to specific device-related complications. This article reviews the most common complications associated with this procedure.

First report of high levels of clindamycin-resistant Propionibacterium acnes carrying erm(X) in Japanese patients with acne vulgaris

2011 ◽  
Vol 39 (9) ◽  
pp. 794-796 ◽  
Author(s):  
Keisuke NAKASE ◽  
Hidemasa NAKAMINAMI ◽  
Norihisa NOGUCHI ◽  
Setsuko NISHIJIMA ◽  
Masanori SASATSU
Keyword(s):  
Propionibacterium Acnes ◽  
Acne Vulgaris ◽  
Japanese Patients ◽  
First Report

scholarly journals Long-term Outcome in Triple-vessel Coronary Artery Disease in Medically Treated Japanese Patients.

1998 ◽  
Vol 39 (1) ◽  
pp. 67-77 ◽  
Author(s):  
Shinichiro NISHIYAMA ◽  
Takashi IWASE ◽  
Yutaro NISHI ◽  
Sugao ISHIWATA ◽  
Nobuyuki KOMIYAMA ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Japanese Patients ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Vessel Coronary Artery Disease ◽  
Artery Disease ◽  
Vessel Coronary Artery

scholarly journals Comparison between the Express Implant and Transscleral Diode Laser in Neovascular Glaucoma

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Faried Mohammed Wagdy ◽  
Adel Galal Zaky
Keyword(s):  
Previous History ◽  
Visual Outcome ◽  
Glaucoma Surgery ◽  
Neovascular Glaucoma ◽  
Panretinal Photocoagulation ◽  
History Of ◽  
Therapeutic Tools ◽  
Endothelial Growth Factor ◽  
Glaucoma Filtration Device ◽  
Filtration Device

Purpose. To compare the outcomes of Ex-PRESS glaucoma filtration device and transscleral cyclophotocoagulation (TSCP) in the management of neovascular glaucoma (NVG). Patients and Methods. A total of 30 eyes (12 express shunts and 18 TSCP) of 28 patients were included. The eyes had NVG with intraocular pressure (IOP) more than 21 mmHg of the maximally tolerated medication treatment after previous panretinal photocoagulation and antivascular endothelial growth factor (anti-VEGF) injection, with no previous history of a cyclodestruction procedure or glaucoma surgery, were randomized either for Ex-PRESS glaucoma filtration device or TSCP. The patients were followed up weekly for the first month and then monthly for 12 months as regard to the IOP, number of topical antiglaucoma drugs required, visual outcome, and postoperative complications. Results. IOP was successfully controlled with both techniques in 83.3% of the eyes. Both techniques had fewer complications and required fewer subsequent procedures. Conclusion. Both the Ex-PRESS glaucoma filtration device and TSCP might constitute safe and alternative therapeutic tools for patients with NVG. However, TSCP is an easier procedure, less time consuming, and does not require a learning curve.

scholarly journals PMD36 Cost-Effectiveness of the Ex-Press Glaucoma Filtration Device in the Netherlands

2011 ◽  
Vol 14 (7) ◽  
pp. A250 ◽  
Author(s):  
L. De jong ◽  
A. Lafuma ◽  
A.S. Aguade ◽  
O. Clément ◽  
G. Berdeaux
Keyword(s):  
Cost Effectiveness ◽  
The Netherlands ◽  
Glaucoma Filtration Device ◽  
Filtration Device

scholarly journals Long-term Outcome in Double- vessel Coronary Artery Disease in Japanese Patients.

1997 ◽  
Vol 38 (2) ◽  
pp. 181-189 ◽  
Author(s):  
Shinichiro NISHIYAMA ◽  
Takashi IWASE ◽  
Yutaro NISHI ◽  
Sugao ISHIWATA ◽  
Nobuyuki KOMIYAMA ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Japanese Patients ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Vessel Coronary Artery Disease ◽  
Artery Disease ◽  
Vessel Coronary Artery
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