Abstract: Objective To evaluate the efficacy and safety of Ex-PRESS miniature glaucoma device implantation combined with anti-VEGF for neurovascular glaucoma. Design Prospective interventional case series. Participants 16 eyes of 16 patients with neurovascular glaucoma who underwent Ex-PRESS miniature glaucoma device implantation in Tongren Hospital from March 2012 to October 2013. Methods All patients underwent Ex-PRESS miniature glaucoma device implantation on 5-10 days after intravitreous injection 0.5 mg ranibizumab. Followed up was performed at day 1, day 2, day 3, week 1, week 2, week 3, month 1, month 3, month 6, and month 12 after surgery. Main Outcome Measures Intraocular pressure (IOP), numbers of anti-glaucoma medication and postoperative complications. Results Pre-operation mean IOP was 44.6±17.8 mmHg in 16 patients. IOP after Ex-PRESS surgery was (12.6±3.5), (13.8±7.5), (17.5±6.5), and (22.6±9.5) mmHg respectively at month 1, month 3, month 6, and month 12 after surgery. The number of anti-glaucoma medication was (3.2±1.4) before operation and (0.6±0.2) after operation. At the last following up, the complete success rate was 81.3%, and qualified success rate was 87.5%. The postoperative complications included shallow anterior chamber (3 eyes), hyphema (2 eyes), choroidal effusion (2 eyes) and IOP elevation (>30 mmHg) (2 eyes). Conclusions Implantation of Ex-PRESS miniature glaucoma device combined with anti-VEGF treatment can stable lowering IOP and has fewer complications for neurovascular glaucoma. It can be considered as alternative method for management of neurovascular glaucoma. (Ophthalmol CHN, 2014, 23: 256-260)

Key words: neurovascular glaucoma, Ex-PRESS miniature glaucoma device