# Changes in anterior segment parameters following insertion of ExPRESS mini glaucoma implant vs. trabeculectomy

## TL;DR

This study compares how two glaucoma surgeries affect eye structures, finding both lower eye pressure and temporary changes that fade over time.

## Contribution

The study provides a direct comparison of anterior segment changes after ExPRESS shunt implantation and trabeculectomy surgeries.

## Key findings

- Both surgeries significantly reduced intraocular pressure at 3 months.
- ExPRESS caused temporary changes in corneal astigmatism and chamber depth on day 1.
- Trabeculectomy also caused temporary astigmatism changes on day 1.

## Abstract

To compare changes in anterior segment parameters following ExPRESS Mini
Glaucoma Shunt surgery vs. trabeculectomy using the Pentacam rotating
Scheimpflug camera.

In this prospective, comparative study, 27 patients with glaucoma treated at
the Rabin Medical Center from 2009 to 2013 were enrolled in this prospective
comparative study: 19 participants (19 eyes) underwent ExPRESS shunt
implantation and 12 (13 eyes) underwent trabeculectomy. Changes in anterior
chamber parameters at postoperative day 1 and postoperative month 3 were
evaluated on Scheimpflug images.

Intraocular pressure decreased significantly from baseline in both groups.
The decrease in both groups was similar at postoperative month 3 (p=0.82).
ExPRESS surgery caused a transient increase in posterior corneal astigmatism
(p=0.008) and a transient decrease in anterior chamber depth (p=0.016) and
volume (p=0.006) on postoperative day 1. At postoperative month 3, these
parameters were no longer statistically significant (p=0.65, p=0.51, and
p=0.57 respectively). Trabeculectomy caused a transient increase in anterior
and posterior corneal astigmatism on postoperative day 1 (p=0.003 and
p=0.005, respectively), which were not evident at postoperative month 3
(p=1.0 and p=1.0, respectively). At postoperative month 3, both ExPRESS and
trabeculectomy showed similar changes in anterior chamber parameters.

Both ExPRESS mini glaucoma implant and trabeculectomy significantly decreased
intraocular pressure and had transient effects on anterior segment
parameters, with minor differences between the methods.