Purchase this article with an account.
R. M. Knape, T. Szymarek, M. F. Smith; Long-Term Results of Eyes With Glaucoma Drainage Device and Penetrating Keratoplasty. Invest. Ophthalmol. Vis. Sci. 2010;51(13):4440.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To report long-term results of eyes with glaucoma drainage devices (GDD) and penetrating keratoplasty (PK). To date, the longest follow-up data reporting cornea and glaucoma data in eyes with both GDD and PK is an average of 3 years. We present data on glaucoma control and corneal graft survival at 5 years of follow-up.
retrospective, noncomparative review of all patients who underwent both GDD (Baerveldt, Shocket, Molteno) and PK between January 1, 1988 and December 31, 2003 at an academic institution. Thirty eyes of 28 patients were studied. The success of the GDD and PK were assessed using Kaplan-Meier statistical analysis. Glaucoma outcome measures included comparison of intraocular pressure and the number of glaucoma medications before and during the study period, as well as need for subsequent glaucoma surgery. Corneal outcome measures included comparison of Snellen visual acuity and corneal clarity before and during the study period, as well as graft rejection, failure, and need for subsequent corneal surgery.
The mean preoperative intraocular pressure was 29 mmHg on a mean of 2.6 glaucoma medications. At 5 years follow-up, the mean IOP was 12.8 mmHg on a mean of 1.0 glaucoma medications. GDD implantation successfully controlled glaucoma in 92% of eyes at 5 years. Graft rejection occurred in 38% eyes, and graft failure occurred in 50% of eyes. Grafts remained clear in 96%, 79%, 71%, 54% and 50% at 1, 2, 3, 4, and 5 years, respectively. Failure of glaucoma control was associated with prior intraocular surgeries and certain glaucoma diagnoses. Failure of the PK was also associated with prior intraocular surgeries, poor glaucoma control and certain corneal diagnoses. Complications occurred in 17% of eyes.
GDD implantation can provide glaucoma control in a high percentage of eyes with PK. The success of PK is low at 5 years (50%). Surgical complications are associated with poor glaucoma and cornea outcomes.
This PDF is available to Subscribers Only