Comparative analysis of the graft survival and endothelial cell density in Ahmed glaucoma valve implantation vs maximal tolerable medical therapy in penetrating keratoplasty with glaucoma

Session Details

Session Title: Presented Poster Session: Surgical Cornea

Venue: Poster Village: Pod 2

First Author: : S.Wy SOUTH KOREA

Co Author(s): :    Y. Kim   J. Jeoung   M. Kim                 

Abstract Details

Purpose:

To compare the effect of Ahmed glaucoma valve (AGV) implantation vs. maximal tolerated medical therapy (MTMT) on the endothelial cell density and the survival of the graft in patients with penetrating keratoplasty (PKP).

Setting:

Retrospective medical chart review of 25 eyes in 25 patients who underwent PKP and treated with MTMT or AGV implantation for the management of glaucoma which had been developed after PKP at Seoul National University Hospital between January 2010 and February 2017.

Methods:

The patients who were followed-up at least 12 months after the glaucoma treatment were included. PKP was done by one corneal surgeon (M.K. Kim). Either Ahmed glaucoma valve implantation or maintenance of MTMT were decided and conducted by two glaucoma specialists (Y.K. Kim or J.W. Jeoung). Non corrected visual acuity, intraocular pressure, endothelial cell density, corneal thickness, number of anti-glaucoma medications, presence of epithelial keratopathy and graft survival were compared between treatment groups in each time point (inter-group analysis) or between baseline and following parameters after treatment in each group (intra-group analysis).

Results:

There were no significant differences in visual acuity and corneal thickness between the two groups or in each group over time. Both groups showed significant reduction of IOP compared to baseline IOP (AGV, P=0.003; MTMT, P=0.027), and IOP reduction was greater in AGV group than in MTMT group (P = 0.005). There were significant ECD reductions for each group between baseline and 6 month (AGV, P=0.033; MTMT, P=0.001), but there was no difference between the two groups. Median survival time of the graft showed no significant difference. The percentage of epithelial keratopathy was higher in MTMT group (P = 0.012).

Conclusions:

The effect of AGV implantation were comparable to the effect of MTMT on the endothelial cell density or the graft survival in patients with PKP for at least 12 months.

Financial Disclosure:

None