Mr.Cheng,male,63 years old
现病史：患者20年前无明显诱因发现右眼渐进性视物不清，伴间断眼疼、头疼。1月前在外院门诊检查，诊断为“右眼青光眼 右眼白内障”，给予派立明 卢美根局部点眼降眼压，效果不佳。遂入我院手术治疗。
Present history: The patient complained of vision decrease in the right eye for twenty years with occasional eye pain and headache. The diagnosis of glaucoma cataract of the right eye was made in other hospital and he was administrated brinzolamide eye drops and lumigan eye drops, Unfortunately, the effect was not satisfactory. Then, he was admitted for further surgical therapy to lower the intraocular pressure.
Past history: The patient underwent the hard palate neoplasm resection three years ago.
Physical examination: Body state is in good condition generally.
UBM: ACD 2.20mm(OU), the whole anterior chamber angle is open, with the iris bombed backwardly.
Visual Field: Paracentral scotoma(OU)
Primary open angle glaucoma OU
Senile cataract OU
The right eye underwent phacoemulsification and OPL implantation and EXPRESS drainage nail implantation.
At 4weeks after operation,
The filtering bleb was diffused, the position of the drainage nail was good, the anterior chamber was deep, ,the IOL was centered in the capsule, and the IOP was 14.2 mmHg.
Glaucoma miniature drainage nail implantation surgery is a new type of extraocular drainage operation. The drainage nail is made of stainless steel, has good histocompatibility, has no valve and the length is about 3mm. the drainage nail can be divided into drainage tube, short process, and wing collar in the structure. The area of the drainage nail is small, which will disturb the extraocular muscles and surrounding tissues minimally. The drainage nail is suitable for all open angle glaucoma patients.
The mechanism of Ex-PRESS drainage nail is identical to the traditional trabeculectomy, with the aqueous humor flowed from anterior chamber to subconjunctival space. The nail can be placed directly under conjunctiva flap or under the scleral flap. The former is simple to operate, but can lead to early persistent low intraocular pressure and late conjunctival erosion. The latter can be reduce postoperative lower intraocular pressure rate, especially for patients with high risk for filtration surgery failure.