Advances in the Surgical Management of Glaucoma—The Role of the EX-PRESS® Glaucoma Filtration Device

By reducing intraocular pressure (IOP), we aim to arrest the glaucomatous process. Our strategies include medical, laser, and surgical techniques. Trabeculectomy is the gold standard drainage surgery to achieve this; as there can be a high degree of variability in the procedure and its success depends on bleb creation, with the challenges of wound healing modulation, results remain unpredictable. Several devices are being assessed to try to achieve ‘minimally invasive glaucoma surgery’. While results will take some years to evaluate rigorously, it seems IOP levels by these means lie in the mid-teens. These minimally invasive glaucoma surgery techniques therefore would appear to be destined for patients whose glaucomatous damage is relatively mild to moderate and whose target IOPs fall into this range. To simultaneously achieve lower IOPs for patients with more advanced visual loss, efforts have been made to ‘fine-tune’ trabeculectomy. Use of the EX-PRESS® Glaucoma Filtration Device (GFD) under a scleral flap is one such approach. How does the EX-PRESS® GFD benefit the conventional trabeculectomy procedure? What tips and tricks contribute to its success? How safe is it? Is the additional cost to our health systems justifiable? This symposium, sponsored by Alcon, set out to try to answer these questions.