Glaucoma Clinical Trial
Official title:
Express Implant Versus Trabeculectomy in a Fibrotic Bleb With Late Failure After Previous Trabeculectomy
To compare between outcome of Express implant and subscleral trabeculectomy (SST) in management of glaucoma after previous trabeculectomy with a fibrotic bleb.
Trabeculectomy is the main glaucoma surgery. Despite the good decline in intraocular pressure
(IOP) that occur rapidly after the procedure, there is still failure occurring due to
progressive subconjunctival fibrosis, with associated increased IOP.
If the bleb is revived by needling with adjunctive 5-fluorouracil (5FU) and mitomycin C (MMC)
that used intraoperatively for the majority of these cases , the associated rise in IOP was
controlled if the revision occured early within the first three months after surgery. But
less success occurred if the bleb revision was delayed.
If these interventions fail, alternative approaches include new augmented trabeculectomy or
aqueous shunt implantation.
Express shunt allows aqueous to pass from anterior chamber to subconjunctival space like
trabeculectomy .Express shunt is a non valved shunt, It has an advantage of less traumatic,
less complications, low diffuse bleb and high success rate.
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