Ex-Press® Glaucoma Filtration Device

What is the Ex-Press® Glaucoma Filtration Device?

The Ex-Press® is a glaucoma filtration device designed to treat open angle glaucoma.

What is Glaucoma?

Glaucoma is a multi factorial ocular disease in which the intraocular pressure is elevated (most cases).The intraocular pressure causes damage to the optic nerve in the back of the eye. There are cases in which the intraocular pressure is normal but still causes damage to the optic nerve (low or normal pressure glaucoma).

How does the Ex-Press® Glaucoma Filtration Device Work?

The Ex-Press® device helps drain the fluid (aqueous humor) inside the eye through the sclera (white portion of the eye) and underneath the conjunctiva (outer coating of tissue over the sclera). This fluid forms a bleb or bubble of fluid under the conjunctiva where it is absorbed. The Ex-Press® device is implanted under a scleral flap into the anterior chamber. The extent or rate of drainage and the intraocular pressure is controlled by the hydrodynamic structure of the Exp-Press® device. The Ex-Press device is manufactured from implantable stainless steel. It is a 2-3 mm long and 0.4 mm diameter tube.

Features of the Ex-Press Glaucoma Filtration Device

  1. A cannula for draining fluid from the eye
  2. A plate to prevent excessive penetration
  3. A spur to prevent extrusion of the device
  4. Reverse orifice near the distal end, which provides an alternative opening for drainage of fluid in case of occlusion of the primary opening

Ex-Press® Glaucoma Filtration Device Indication

The Ex-Press® device is designed to reduce the intraocular pressure in glaucoma patients in which medical and/or conventional surgical treatment have failed.

Complications Associated with the Ex-Press® Glaucoma Filtration Device

Glaucoma filter surgery          12.39%

Device removed                       12.39%

Hyphema (blood)                     11.50%

Revision of bleb                        10.62%

Device iris touch                         9.73%

Shallow anterior chamber       7.96%

Hypotony                                    7.08%

Tenon cyst                                  6.19%

Corneal complication               6.19%

AC reformation                         5.31%

Device exposure                       5.31%

Choroidal complication           5.30%

Bleb leakage                              4.42%

Cataract                                     4.42%

Flat AC                                       4.42%

Device malfunction                 3.54%

Device reposition                    2.65%

Other complications less       2.00%

Ex-Press® Glaucoma Filtration Device Efficiency in Clinical Studies

The cumulative success at one year was 75% to 79%

Contraindications of the Ex-Press® Glaucoma Filtration Device

Presence of ocular disease such as uveitis, ocular infection, severe dry eye, severe blepharitis

Pre existing ocular pathology that the eye surgeon feels would cause a problem

Patient with acute angle closure glaucoma

Summary

The Ex-Press® glaucoma filtration device is becoming a popular choice when treating patients with glaucoma who have failed with other treatments. The device can provide several increased safety factors compared to traditional filter surgery (trabeculectomy).

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