June 2015
Volume 56, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2015
Outcome of Descemet stripping automated endothelial keratoplasty in eyes with glaucoma drainage devices
Author Affiliations & Notes
  • Kevin Lai
    Ophthalmology, New York Eye and Ear Infirmary, New York, NY
  • Joann Kang
    Ophthalmology, Montefiore Medical Center, Bronx, NY
  • David Ritterband
    Ophthalmology, New York Eye and Ear Infirmary, New York, NY
  • Jeffrey M Liebmann
    Ophthalmology, New York Eye and Ear Infirmary, New York, NY
  • John Seedor
    Ophthalmology, New York Eye and Ear Infirmary, New York, NY
  • Footnotes
    Commercial Relationships Kevin Lai, None; Joann Kang, None; David Ritterband, None; Jeffrey Liebmann, Alcon Laboratories, Inc. (F), Alcon Laboratories, Inc. (F), Allergan, Inc. (F), Bausch&Lomb (F), Carl Zeiss Meditec, Inc. (C), Diopsys Corporation (C), Heidelberg Engineering (F), Merz Pharmaceuticals, Inc. (F), National Eye Institute (F), New York Glaucoma Research Institute (R), Optovue, Inc. (F), Quark Pharmaceuticals Inc. (C), Reichert, Inc. (F), SOLX, Inc. (F), Sustained Nano System (P), Topcon Medical Systems (F), Valeant Pharmaceuticals (F); John Seedor, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2015, Vol.56, 1570. doi:
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    • Get Citation

      Kevin Lai, Joann Kang, David Ritterband, Jeffrey M Liebmann, John Seedor; Outcome of Descemet stripping automated endothelial keratoplasty in eyes with glaucoma drainage devices. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):1570.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

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.

Methods: A retrospective chart review was conducted on 43 eyes that underwent DSAEK by two surgeons with either simultaneous insertion of a 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 occured in 17%, 33%, 50%, 36% of eyes respectively. In total, donor detachment occurred in 37% of 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 all eyes. The 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. Larger sample size is needed confirm these hypotheses.

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