Working Paper Article Version 1 This version is not peer-reviewed

Phacotrabeculectomy versus Phaco with Implantation of the Ex-PRESS Device: Surgical and Refractive Outcomes—A Randomized Controlled Trial

Version 1 : Received: 5 December 2020 / Approved: 7 December 2020 / Online: 7 December 2020 (09:43:29 CET)

A peer-reviewed article of this Preprint also exists.

Konopińska, J.; Byszewska, A.; Saeed, E.; Mariak, Z.; Rękas, M. Phacotrabeculectomy versus Phaco with Implantation of the Ex-PRESS Device: Surgical and Refractive Outcomes—A Randomized Controlled Trial. J. Clin. Med. 2021, 10, 424. Konopińska, J.; Byszewska, A.; Saeed, E.; Mariak, Z.; Rękas, M. Phacotrabeculectomy versus Phaco with Implantation of the Ex-PRESS Device: Surgical and Refractive Outcomes—A Randomized Controlled Trial. J. Clin. Med. 2021, 10, 424.

Abstract

To compare surgical and refractive outcomes between phacotrabeculectomy (P-Trab) and phaco with Ex-PRESS (P-Ex-PRESS) for glaucoma at 6-month follow-up. This prospective randomized controlled trial included 81 eyes; 43 (53%) and 38 (47%) were assigned to the P-Ex-PRESS and P-Trab groups, respectively. Refraction, intraocular pressure (IOP), and best-corrected visual acuity were measured. Refractive change was described by analyzing the magnitude of the cylinder, and polar analysis assessed the change in trend of astigmatism [with-the-rule, against-the-rule (ATR), oblique] evaluating mean astigmatism in centroid form. All patients showed statistically significant postsurgical decrease in IOP (P<0.05). There were no differences neither between the groups for postoperative IOP or visual outcomes, nor in astigmatism before or after surgery (P=0.61, P=0.74). In both groups, the mean pre- and postoperative astigmatism was ATR and OBL, respectively. Pre- and postoperative centroids in the P-Ex-PRESS group were 0.44±1.32 D at 177˚ and 0.35±1 D at 8˚, respectively, (P=0.5) and in the P-Trab group, 0.16±1.5 D at 141˚ and 0.39±1.38 D at 29˚, respectively (P=0.38). Both P-Ex-PRESS and P-Trab showed comparable antihypertensive efficacy in treating open-angle glaucoma in a 6-month period. Pre- and postoperative astigmatism did not differ between groups. The groups showed comparable results for final visual acuity.

Keywords

astigmatism; glaucoma; intraocular pressure; phacotrabeculectomy; Ex-PRESS device

Subject

Medicine and Pharmacology, Immunology and Allergy

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