IntroductionTo evaluate the efficacy and safety of the Ex-Press Miniature Glaucoma Implant in reducing intra-ocular pressure, implanted under scleral flap with phacoemulsification and IOL implantation in patients with open angle glaucoma in comparison with patients operated for combined cataract and glaucoma surgery.Objectives’ and MethodsTwenty eyes of 20 patients with open angle glaucoma and cataract were considered for our study. Ten eyes (group one) underwent Clear-cornea phacoemulsification with IOL implantation combined with Ex-Press (R-50) implantation under scleral flap. Ten eyes (group two) were operated with combined trabeculectomy and cataract surgery. The mean follow up was 9,41+ 2,5 months after surgery. Each patient underwent ophthalmic examinations (IOP, visual field, gonioscopy, cup/disc ratio) before and after surgery.ResultsThe IOP decreased from 22.48+5.7mmHg preoperatively to 10.8+5.75 mmHg at 6 months and 13.4+1.5 mmHg after the first post operative year without medical treatment in group one. The IOP decreased from 21.80+4.5 mmHg preoperatively to 10.9+2.35 mmHg at 6 months and 13.2+2.9 mmHg after the first post operative year without medical treatment in group two. One eye of group one, suffered from athalamia but recovered without surgical treatment. We did not observe any infection, corneal erosion, or Ex-PRESS extrusion.DiscussionThere were no statistical differences between results obtained with phaco-trabeculectomy and and phaco-Express implant under scleral flap regarding IOP or early complications.ConclusionAfter one year the Ex-Press implant under scleral flap was safe and effective for reducing IOP and antiglaucoma medication in open angle glaucoma eyes in combination with phacoemulsification and IOL implantation.