Could Ex-PRESS miniature implantation replace the trabeculectomy in China?

Ex-PRESS miniature implantation is a new alternative of anti-glaucoma surgeries due to its advantages, such as simpler operation, similar efficacy to trabeculectomy and less complications.Could Ex-PRESS miniature implantation replace the trabeculectomy? Studies showed that Ex-PRESS implantation has more significant advantages to those patients with high risk for trabeculectomy but dose not has dominant benefits to those prone to failure of trabeculectomy from bleb scarring.The Ex-PRESS implantation requires a relative wide angle so as to have enough space to avoid the device accessing to corneal endothelium, iris or lens.So it is unsuitable for angle-closure glaucoma with higher incidence in China.In addition, the cost-effect for Ex-PRESS implantation should also be fully considered when this method could be put into practice in the near future in China.Ex-PRESS implantation seems to be unable to displace trabeculectomy.The merits and demerits for Chinese patients still need to verify by Chinese own evidence-based studies.