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N. Ragusa, C. Y. Shih, D. D. Hayes, I. J. Udell; Intraocular Pressure Variations After Descemet’s Stripping Automated Endothelial Keratoplasty in a Retrospective Series With 1 Year Follow-Up. Invest. Ophthalmol. Vis. Sci. 2010;51(13):768.
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© ARVO (1962-2015); The Authors (2016-present)
To report intraocular pressure (IOP) changes up to 1 year after Descemet’s stripping automated endothelial keratoplasty (DSAEK) for the treatment of endothelial dysfunction.
Retrospective case series of 44 patients who underwent DSAEK by a single surgeon with at least 12 months follow-up. DSAEK was performed for the treatment of Fuchs’ endothelial dystrophy, pseudophakic bullous keratopathy, and failed corneal grafts. Main outcome measures included IOP, amount of steroid drops, and number of glaucoma medications used pre-operatively, as well as at 6 and 12 months post-operatively. Results were compared in patients with and without a prior history of glaucoma.
In the non-glaucomatous group (n=36) the mean preoperative IOP was 15.6 mm Hg, steroid drop use was 0.7, and glaucoma medication use was 0. At postoperative months 6 and 12 respectively, the mean IOP was 17.6 and 16.5 mmHg. Steroid drop use was 2.1 and 1.0 and glaucoma medication use 0.1 and 0.5 respectively. This translates to a 6% increase in IOP by postoperative month 12. 5 of 36 (14%) required addition of glaucoma drop therapy to control their IOP.Preoperatively, in the glaucoma group (n=8) the mean IOP was 14.9 mm Hg, steroid drop use 1.7, and IOP medication use 1.6 per day. At postoperative months 6 and 12 respectively, the mean IOP was 16.3 and 14.0 mmHg. Steroid drop use was 2.3 and 1.7 respectively and IOP medication use was 1.4 and 1.4 respectively. Overall there was a 12.5% decrease in mean IOP by 12 months in the glaucoma group. One patient no longer required glaucoma drops and 2 patients (25%) required the addition of an additional glaucoma drop to control their IOP.No patients in either group required additional glaucoma surgery or laser.
In our series, a small percentage of patients undergoing DSAEK with no history of glaucoma experienced a transient increase in IOP. Patients with underlying glaucoma did not experience a statistically significant trend to increased IOP post-DSAEK at one year.
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