Ex-PRESS™ Mini Glaucoma Shunt

Ex-PRESS™ Mini Glaucoma Shunt implantation represents the latest breakthrough in glaucoma filtration surgery.  It is a less invasive alternative to trabeculectomy to reduce intraocular pressure (IOP).  The Ex-PRESS is inserted into the anterior chamber of the eye and is covered under a scleral flap.  The operation eliminates the need for an iridectomy and no removal of scleral tissue is necessary.

Ex-PRESS™ shunt surgery reduces the pressure in the eye by giving the fluid a means to drain out more efficiently and in a predictable way.  The novel procedure offers advantages over standard trabeculectomy through its design and intention of offering a fast and simple glaucoma operation. 

This treatment is suitable for several types of glaucoma including open-angle, narrow-angle, neovascular and inflammatory glaucoma. It is generally performed on patients who have not, or are not expected to, respond well to other medical or surgical treatments.  This procedure is usually performed by a glaucoma specialist, who has experience in not only the procedure itself, but also postoperative care, which is very important.

Ex-PRESS™ Shunt Surgery is for those:

• with uncontrolled glaucoma
• where other treatment methods have failed

What to expect on surgery day:

You will arrive at the surgery center approximately 60 minutes prior to your procedure. Once you have been checked-in and settled comfortably, you will be prepared for surgery. The area around your eyes will be cleaned and a sterile drape will be applied. You may be given a sedative to help you relax. Your eye will be numbed with local anesthetic or in some cases, general anesthesia is used.  

Using advanced microsurgical techniques and equipment, your doctor will place the Express implant and possibly use anti-scarring medicine. The procedure is usually finished within one hour. 

Postoperatively, you will use eye drops which will be adjusted as needed during your follow up visits. Regular follow-up exams track pressure changes in your eye and ensure that the glaucoma implant is working successfully.

Physical activity will be limited immediately after surgery. It is best to avoid bending, lifting, or straining as directed by your surgeon.

Realistic expectations:

The success rate for this type of surgery is approximately 50-80 percent depending on the type and severity of glaucoma as well as past surgical history.  Each individual’s eyes are unique and further treatments may be required.

Complications of glaucoma surgery that may occur include:

• High or low eye pressure
• Inflammation or infection in the eye.
• Bleeding the eye (hyphema)
• Movement of the tube affecting vision or proper function of the eye.
• Eye muscle imbalance causing double vision.

Express shunt surgery is an important advancement in the surgical treatment of glaucoma.   As with any procedure, the potential benefits must be weighed against the potential risks before proceeding with surgery.

If you and your doctor decide that Express shunt surgery is an option for you, you will be given additional information about the procedure that will allow you to make an informed decision about whether to proceed. Be sure you have all your questions answered to your satisfaction.

If you would like more information about this procedure you can make an appointment or contact the office for additional information.

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