Observation of curative effects of Ex-PRESS and AGV implantation in the treatment of refractory glaucoma

The curative effects of Ex-PRESS implantation and Ahmed glaucoma valve (AGV) implantation in the treatment of refractory glaucoma were compared. A total of 68 patients (76 eyes) with refractory glaucoma treated were randomly divided into Ex-PRESS group and AGV group. Results showed that the intraocular pressure IOP in both Ex-PRESS group and AGV group after operation was significantly decreased compared with that before operation (P<0.001). At 3, 6 and 9 months after operation, IOP in Ex-PRESS group was significantly lower than that in AGV group (P<0.05). At the end of follow-up, BCVA of patients in both groups after operation was slightly decreased compared with that before operation (P>0.05). There was no statistically significant difference in BCVA between the two groups of patients (P>0.05). Moreover, the corneal endothelial cell counts of patients in both groups after operation were obviously decreased compared with those before operation (P<0.05). The number of anti-glaucoma drugs applied was decreased from 3.53±0.86 to 0.55±0.60 in Ex-PRESS, and from 3.24±0.88 to 0.89±0.73 in AGV group. At the end of follow-up, the number of anti-glaucoma drugs applied in Ex-PRESS group was smaller than that in AGV group (P<0.05). There was no statistically significant difference in success rate of operation between the two groups at the end of follow-up (log-rank test; P>0.05). Finally, the incidence rates of postoperative complications and surgical intervention rates had no statistically significant differences between the two groups. Ex-PRESS implantation is a safe and effective treatment for refractory glaucoma, characterized by simple operation, small trauma and less pain, which has an equivalent curative effect to AGV implantation; but its control effect on IOP after operation is superior to that of AGV, and the number of anti-glaucoma drugs applied after operation is small.