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S. E. Gorovoy, M. S. Gorovoy, D. R. Caldwell, R. S. Ayyala; Surgical Outcomes of Descemet's Stripping Endothelial Keratoplasty (DSEK) in Patients With Pre-Existing Glaucoma Surgery. Invest. Ophthalmol. Vis. Sci. 2009;50(13):641.
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To report the preliminary data on the surgical outcomes of eyes with prior glaucoma drainage devices (GDD) or trabeculectomy that undergo Descemet’s Stripping Endothelial Keratoplasty (DSEK) for corneal decompensation.
In this ongoing study, we are reviewing the medical records of all glaucoma patients with prior glaucoma surgery who underwent DSEK at two surgical centers (Tulane University Hospital and Gorovoy MD Eye Specialists) between 2004 and 2008.
A total of 30 eyes with prior glaucoma surgery were analyzed at the present time. There was a statistically significant difference in pre-operative and post-operative IOP and number of glaucoma medications in patients with pre-existing GDDs and filtering blebs who underwent DSEK, as a subset of these patients went on to develop filtering bleb failure. Two patients among the GDD group and 4 patients in the trabeculectomy group failed following DSEK. Glaucoma patients with prior filtering shunts or blebs had higher rates (2 times) of DSEK dislocation than previously reported in the literature for patients without glaucoma.
The preliminary data appear to suggest higher complications in glaucoma patients following DSEK. Evolving techniques to minimize DSEK dislocation in patients with filtering shunts or blebs will be presented.
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