Outcome of Descemet's stripping endothelial keratoplasty in eyes with glaucoma drainage devices

Session Details

Session Title: Presented Poster Session: Cornea: Surgical

Venue: Poster Village: Pod 3

First Author: : J.Kang USA

Co Author(s): :    D. Ritterband   K. Lai   J. Liebmann   J. Seedor              

Abstract Details

Purpose:

To compare the outcome of descemet stripping automated endothelial keratoplasty (DSAEK) in eyes with simultaneous insertion of a glaucoma drainage device (GDD), simultaneous repositioning of a GDD through the pars plana, previous insertion of a pars plana GDD and previous insertion of an anterior chamber GDD.

Setting:

The New York Eye and Ear Infirmary of Mount Sinai

Methods:

A retrospective chart review was conducted on 43 eyes that underwent DSAEK by two surgeons with either simultaneous insertion of a pars plana GDD, simultaneous repositioning of a GDD through the pars plana, previous insertion of a pars plana GDD or previous insertion of an anterior chamber GDD (6, 12, 14, 11 eyes, respectively). All patients had accrued 3 or more months of follow-up at the time of analysis. Outcome measures examined included donor dislocation rate, intraocular pressure and graft survival. Mean time of follow-up was 30 months.

Results:

In eyes with simultaneous insertion of a GDD, simultaneous repositioning of a GDD through the pars plana, previous insertion of a pars plana GDD and previous insertion of an anterior chamber GDD, donor detachment occurred in 17%, 33%, 50%, 36% of eyes respectively. In total, donor detachment occurred in 37% eyes. Escalation of glaucoma therapy was required in 0%, 25%,23%. and 36% of eyes respectively. Escalation of glaucoma therapy was required postoperatively in 24% of eyes. Probability of graft survival at 3 years was 44%, 31%, 67%, 61% respectively. Overall cumulative probability of graft survival at 3 years was 48%.

Conclusions:

Eyes that underwent simultaneous insertion of a GDD at the time of DSAEK seem to have a lower incidence of donor detachment and better control of glaucoma than other groups. Probability of graft survival was higher in the previous insertion of a pars plana and anterior chamber GDD groups than the simultaneous insertion of a GDD and simultaneous repositioning of a GDD through the pars plana groups. A larger sample size is needed confirm these hypotheses.

Financial Disclosure:

None