白内障手術併用エクスプレス®手術とエクスプレス®単独手術（有水晶体眼，眼内レンズ眼）との術後早期成績の比較

Comparison of short-term outcome after insertion of Ex-PRESS® device among phakic or pseudophakic eyes and eyes with simultaneous cataract surgery

要約　目的：原発開放隅角緑内障に対するエクスプレス^®挿入後の早期成績の報告。

症例：過去2年間に原発開放隅角緑内障に対してエクスプレス^®を挿入した連続36例48眼を対象とした。18眼では白内障手術を同時に行い（併用群），11眼は有水晶体眼であり，19眼は無水晶体眼であった。これら3群間で術後の眼圧，点眼スコア，1年後の生存率を比較した。

結果：それぞれ群で12か月後の眼圧（mmHg）は，13.8，12.4，12.3で，各群間に有意差はなかった。点眼スコアは，1.9，0.9，2.1で，各群間に有意差はなかった。1年後の生存率は，55.0％，72.7％，60.7％であり，各群問に有意差はなかった。

結論：原発開放隅角緑内障に対するエクスプレス^®の挿入1年後の評価で，眼圧，点眼スコア，1年生存率について，白内障同時手術の有無，有水晶体眼，無水晶体眼の間に有意差はなかった。

Abstract　Purpose：To report one-year outcome after insertion of Ex-PRESS^® device for primary open-angle glaucoma.

Cases and Method：This retrospective study was made on consecutive 48 eyes of 36 cases who received insertion of Ex-PRESS^® device for primary open-angle glaucoma in the past 2 years. Cases were divided into 3 groups. Simultaneous cataract surgery was performed in 18 eyes（triple group）. Eleven eyes were phakic（phakic group）, and 19 eyes were pseudophakic（IOL group）. These 3 groups were evaluated regarding intraocular pressure, medication score, and rate of success one year after surgery. Success was defined as reduction of intraocular pressure by 20％ or more.

Results：Intraocular pressure averaged 17.4, 22.1 and 22.2 respectively before surgery in the 3 groups. It averaged 13.8, 12.4 and 12.3 respectively one year after surgery. The differences were not significant. Medication score averaged 2.9, 3.8 and 3.8 respectively before surgery. It averaged 1.9, 0.9 and 2.1 respectively after surgery. The differences were not significant. Surgery was evaluated as success in 55.0％, 72.7％ and 60.7％ respectively one year after surgery. The differences were not significant.

Conclusion：Insertion of Ex-PRESS^® device for primary open-angle glaucoma resulted in the same one-year outcome regarding intraocular pressure, medication score and rate of success among 3 groups.