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Jonathan B Greene, Brittany Noble, Denise John, Roni M Shtein; Impact of Glaucoma Drainage Device Position on DSAEK Outcomes. Invest. Ophthalmol. Vis. Sci. 2014;55(13):895.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the impact of glaucoma drainage device (GDD) tube location on outcomes of DSAEK.
Retrospective review of 24 consecutive DSAEK cases in patients with an anterior chamber (AC) or pars plana (PP) GDD from 2008-2012. Surgical procedures, graft dislocation, rejection, failure, intraocular pressure (IOP) control and other complications were recorded.
Mean postoperative follow-up in AC (n=16) and PP (n=8) groups was 15 and 23 months, respectively. Rates of graft dislocation were similar at 31 and 25%, respectively. Graft failure rate was increased in the AC group (50% vs. 12.5%), but not statistically significant. Time to failure was significantly shorter in the PP group (5.4 vs. 17 months, p<0.0005). There was no significant difference in pre- or post-operative IOP between the groups. No major retinal complications were encountered in the PP group, though 2 patients developed hypotony.
Pars plana positioning of a GDD can safely control IOP in DSAEK. Decreased graft failure rate in the PP group may reflect a decrease in tube-related endothelial cell trauma. Further investigation into the safety of PP tube placement in patients with concern of corneal complications of an AC positioned GDD is warranted.
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