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Jasbeth Ledesma Gil, Lani Gurria, Jessica Daniela Valencia Aguirre, Alejandro Navas, Enrique O Graue, Curt Hartleben-Matkin; Miniature Glaucoma Shunt Implantation after Keratoplasty. Invest. Ophthalmol. Vis. Sci. 2014;55(13):6147.
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To report the outcomes of patients who underwent miniature glaucoma shunt implantation after secondary glaucoma due to keratoplasty.
A retrospective, non-comparative study of clinical consecutive cases who underwent mini-glaucoma shunt (Ex-PRESS device, Alcon Laboratories, TX) following keratoplasty were included. Briefly, a fornix based conjuntival flap was performed, approximately 50% thickness scleral flap. Mitomycin-C 0.2% placed under Tenon’s capsule. A 25-gauge needle creates entry for mini-shunt. Ex-PRESS model P-50 was inserted. Scleral flap and conjunctiva were closed with 10-0 Nylon. STATA 8.0 and paired t-test were used for statistical analysis.
8 eyes of 8 patients with a mean age of 42.62 years (SD: 17.66, range: 19 to 68). 62.5% male and 37.5% female. Six cases after penetrating keratoplasty, one after deep anterior lamellar keratoplasty, and one after triple procedure. Most of the keratoplasty indications were keratononus (75%), one case due to pseudophakic bullous keratopathy and another case of herpetic keratitis. Mean preoperative IOP was 34 mmHg (SD: 7.78, range: 28-50) decreasing to 11 mmHg postoperatively (SD1: 1.85, range 8-14) [p < 0.001] with or without antiglaucomatous medications. Mean follow-up after mini-glaucoma shunt implantation was 10.12 months (SD: 5.16, range: 5.16). UDVA, CDVA and endothelial cell count did not presented statistically significant differences during follow-up.
Ex-PRESS miniature glaucoma shunt could be an alternative treatment in post-keratoplasty glaucoma resistant to medical treatment. This technique may be helpful, in trying to avoid corneal damage produced by conventional glaucoma procedures.
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