Abstract
Purpose:
To evaluate the impact of glaucoma drainage device (GDD) tube location on outcomes of DSAEK.
Methods:
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.
Results:
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.
Conclusions:
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.
Keywords: 481 cornea: endothelium •
479 cornea: clinical science •
568 intraocular pressure