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SIR, We congratulate Mariotti _et al_1 for their very interesting article ‘Long-term outcomes and risk factors for failure with the EX-press glaucoma drainage device’ in which they report
the long-term outcomes and risk factors for failure with the EX-PRESS shunt implanted under a scleral flap. We would like to point out some issues that we believe need further clarification.
First, in their article the authors report that ‘Two hundred and forty-eight eyes of 211 patients with uncontrolled glaucoma underwent EX-PRESS implantation (with or without cataract
extraction) between September 2000 and September 2009’; however, it is not clear whether the authors excluded patients who had previously undergone cataract surgery and intraocular lens
(IOL) implantation? More importantly, did they exclude patients with complicated cataract surgery? Second, in the 112 eyes that underwent combined surgery, what was the exact technique? Did
they perform the cataract surgery and then the modified trabeculectomy with the EX-PRESS valve or vice versa? Was the cataract surgery in all the eyes uncomplicated? And if not, did they
continue the procedure of the EX-PRESS implantation? Did the authors have any cases where an anterior chamber IOL (ACIOL) or an Artisan type had to be inserted? It would be very interesting
to know whether the EX-PRESS valve works efficiently in the eyes with complicated cataract surgery and whether the EX-PRESS success rates are different in these eyes. REFERENCES * Mariotti
C, Dahan E, Nicolai M, Levitz L, Bouee S . Long-term outcomes and risk factors for failure with the EX-press glaucoma drainage device. _Eye (Lond)_ 2014; 28 (1): 1–8. Article CAS Google
Scholar Download references AUTHOR INFORMATION AUTHORS AND AFFILIATIONS * Department of Ophthalmology, ‘G.Gennimatas’ Hospital of Athens, University of Athens, Athens, Greece I Georgalas, D
Papaconstantinou & C Koutsandrea Authors * I Georgalas View author publications You can also search for this author inPubMed Google Scholar * D Papaconstantinou View author publications
You can also search for this author inPubMed Google Scholar * C Koutsandrea View author publications You can also search for this author inPubMed Google Scholar CORRESPONDING AUTHOR
Correspondence to I Georgalas. ETHICS DECLARATIONS COMPETING INTERESTS The authors declare no conflict of interest. RIGHTS AND PERMISSIONS Reprints and permissions ABOUT THIS ARTICLE CITE
THIS ARTICLE Georgalas, I., Papaconstantinou, D. & Koutsandrea, C. RE: Long-term outcomes and risk factors for failure with the EX-press glaucoma drainage device. _Eye_ 28, 1034 (2014).
https://doi.org/10.1038/eye.2014.87 Download citation * Published: 09 May 2014 * Issue Date: August 2014 * DOI: https://doi.org/10.1038/eye.2014.87 SHARE THIS ARTICLE Anyone you share the
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