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A.S. Prywes, C.H. Marcus, I.J. Udell, R.F. Rothman, J.A. Winokur; Hypotony Associated with Graft Failure in Combined Ahmed Glaucoma Valve Implantation and Keratoplasty vs. Medically Treated Glaucoma and Non–Glaucoma Controls . Invest. Ophthalmol. Vis. Sci. 2006;47(13):17.
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Glaucoma is a significant risk factor for graft failure. Postoperative hypotony may be a risk factor for post keratoplastygraft failure in glaucoma and non–glaucoma patients. Acomparison of penetrating keratoplasty (PK) patients with glaucomaundergoing Ahmed glaucoma valve implants concurrently (PKAGV)Group I, medically treated patients (PKG) Group II and a cohortof non–glaucoma patients (PKNG) Group III would help todelineate the role of hypotony in graft failure.
To study graft failure incidence and hypotony in GroupsI, II and III.
Retrospective review of office charts and hospitalrecords of patients with corneal opacification requiring PKfor various etiologies. 41 Group I eyes, 43 Group II eyes, and40 Group III eyes in whom PK was performed at Long Island JewishMedical Center between August 1994 to April 1999 were included.Only eyes with at least one year follow up, but all failureswere included, regardless of number of months to failure.
Hypotony was present in 20/41 (49%) Group I, 4/43 (9%)Group II eyes, 4/37 (11%) Group III eyes. Hypotony related graftfailure occurred in 9/20 (45%) of Group I, and 2/4(50%) in GroupsII and III. Overall graft failure at Years 1, 3, and 4 was comparablein all three groups:Chi2 Wilcoxen–Groups I vs II: 0.53;I vs III: 0.2; II vs III: 0.32.
Post operative graft failure after hypotony occurredin 45–50% of all groups. Hypotony after PKAGV occurs morefrequently than after PKNG and PK, but overall graft failurewas comparable in all three groups.
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