摘要： To report on the use neodymium laser for treatment of eyes with IOP rise following Ex-Press glaucoma filtration device implantation. We retrospectively examined the medical records of 73 patients who underwent Ex-Press device implantation at four medical institutions between 2007 and 2015 and subsequently developed an IOP rise. Enrollment criteria included patients with POAG on whom post treatment IOP data is available. Indications for treatment with neodymium laser were an IOP above target and a flat bleb. In order to disrupt the presumed micro-blockage, the neodymium laser was aimed at the axial and relief ports of the Ex-Press device. Applanation tonometry measurements were followed up after neodymium treatment for variable time intervals. Success was defined as an IOP < 18 mm Hg at 6 months without further surgical or laser-based glaucoma interventions. 73 charts were reviewed. 20 patients were excluded due to insufficient data or a diagnosis other than POAG. Data from 53 eyes of the remaining 53 patients was analyzed. The mean duration between Ex-Press implantation and rise in IOP requiring neodymium intervention was 34.2 months (range, 1.1 – 67.2). We found a statistically significant immediate IOP lowering effect in all eyes, with a mean IOP drop of 13.34 +/- 8.99 mm Hg, and a mean post treatment IOP of 14.30 ± 8.57 mm Hg (P<0.0001). Of a subset of 43 eyes on which 6 months follow up IOP data was available, 11 eyes required further glaucoma intervention (surgery or laser based); four eyes had an IOP of 18 or greater at 6 months. In the remaining 28 successful eyes, a sustained IOP below 18 mm Hg was observed at 6 months, with a mean pressure of 11.39 ± 4.03 mm Hg (P < 0.0001). Hypotony (IOP < 5) occurred in 3 eyes immediately following treatment and self-resolved by 1 week. Our retrospective case series suggests that neodymium laser is a potential consideration in eyes with sustained IOP rise after Ex-Press device implantation.