Ex-PRESS shunt for choroidal fluid drainage in uveal effusion syndrome type 2: a potentially novel technique.

Uveal effusion syndrome (UES) was reported by Schepens and Brockhurst in 1963,1 and later described as a nanophthalmic disorderwith a scleral abnormality.2 Gass3 described idiopathicUES and hypothesized that the causewas a congenital anomalyof the sclera and vortex veins that was related to aging, hormonal changes, or impairment of the permeabilityof the sclera.Using histologicalmethods,Trelstadet al4 reported the scleral abnormalities inUES. In addition, Forrester et al5 observed migration of retinal pigment epithelial cells into the subretinal space. For the treatment of UES, Brockhurst6 described good surgical results with decompression of the vortex veins by scleral resection with a sclerotomy. Gass3 reported an effective surgical procedure with a sclerectomy and sclerostomy without decompression of thevortexveinsowingtothedifficultyof isolatingthevortexveins. Uyama et al7 treated 19 eyes of 16 patients with UES by making a two-third–thickness scleral flap andperforminga scleral excision to expose the underlying choroid. The Ex-PRESS shunt (Alcon Laboratories) glaucoma implant is a small (2to3-mm–longand0.4-mm–diameter tube) stainless steel nonvalved device that was designed to lower intraocular pressure byshuntingaqueoushumor fromtheanterior chamber into thesubconjuntival space under a partial-thickness scleral flap space adjacent to the limbus.8 In thecurrent study,we report the surgical outcomesof theuse of an Ex-PRESS shunt device for choroidal drainagewithout vortex vein decompression for themanagement of 3 eyes with UES.