I began using the EX-PRESS Glaucoma Filtration Device (Alcon Laboratories, Inc., Fort Worth, TX) in July 2006, after it became popularized as a subscleral flap procedure in response to the work of Eli Dahan, MD, of South Africa.1 I conducted a comparison study of the eyes I implanted with the EX-PRESS device between July 2006 and June 2007 and those I had treated with trabeculectomy between July 2005 and June 2006.2 The 9- month efficacy results showed that IOP was equivalent in both groups (about 11 mm Hg), but there was much less hypotony in the eyes implanted with the EX-PRESS device. I now frequently use the EX-PRESS Glaucoma Filtration Device in many cases in which I would perform a trabeculectomy procedure. Fortunately, insurance coverage of the device has been expanding.
Although I would not call the implantation of the EX-PRESS Glaucoma Filtration Device a simple procedure—it still requires meticulous surgical technique—the learning curve is fairly low. Clearly, this device offers several advantages for which I favor this procedure over trabeculectomy.
This monograph features articles by other respected surgeons who have had a similar experience with the EX-PRESS device. Read on to hear their opinions and learn their implantation techniques and pearls.
— Leon Herndon, MD
