May 2008
Volume 49, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2008
Is DSAEK Safe in Patients With Previous Glaucoma Filtering Surgeries?
Author Affiliations & Notes
  • D. J. Friend
    Lions Sight and Hearing Fndtn, Portland, Oregon
  • P. M. Phillips
    Devers Eye Institute, Portland, Oregon
  • M. A. Terry
    Devers Eye Institute, Portland, Oregon
  • N. Shamie
    Devers Eye Institute, Portland, Oregon
  • D. Doot
    Oregon Health Science University, Portland, Oregon
  • H. Saad
    Devers Eye Institute, Portland, Oregon
  • Footnotes
    Commercial Relationships  D.J. Friend, None; P.M. Phillips, None; M.A. Terry, small royalty interest in the instruments used in this procedure, P; N. Shamie, None; D. Doot, None; H. Saad, None.
  • Footnotes
    Support  Lions Sight and Hearing Foundation
Investigative Ophthalmology & Visual Science May 2008, Vol.49, 2333. doi:https://doi.org/
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    • Get Citation

      D. J. Friend, P. M. Phillips, M. A. Terry, N. Shamie, D. Doot, H. Saad; Is DSAEK Safe in Patients With Previous Glaucoma Filtering Surgeries?. Invest. Ophthalmol. Vis. Sci. 2008;49(13):2333. doi: https://doi.org/.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: : To evaluate the intra operative and post operative complications and outcomes of DSAEK in patients with previous glaucoma filtering surgeries

Methods: : Retrospective case series of all patients with glaucoma filters, who underwent DSAEK at one institution

Results: : 22 eyes of 20 patients were included in the study (Sixteen trabeculectomies (trabs) and 6 glaucoma drainage devices (GDDs)). Additional procedures performed included, 3 anterior vitrectomies, 2 cataract extractions with IOL placement, 1 IOL exchange, 2 sutured IOLs, 2 iridoplasties, and 2 tube revisions. Intra-operative complications included 2 compromised blebs and one loss of donor tissue do traumatic manipulation. The average post-operative follow up was 260 days (28-628 days). Post-operative complications included 1 dislocation, 1 decentered graft, one retinal detachment, 2 graft rejection episodes and one late endothelial failure. There were no primary graft failures. In 4 eyes, one or more new glaucoma drops were initiated post operatively. No additional glaucoma surgeries were performed post operatively. The average visual acuity at the last exam was 20/143, representing an improvement from pre-op (p=<.001). 21 of 22 grafts were clear at the last follow up exam and no eye lost vision. The average endothelial cell density at 6 months was 1820 (1126 - 2500) and the average cell loss was 32% (13%-55%) (n=4)

Conclusions: : In this series, eyes with glaucoma filters lead to a significant improvement in vision with no primary graft failures and reasonably low dislocation (4.5%) and graft decentration (4.5%) rates. The overall intra-operative complication rate of 14% may, in part, be explained by the complexity of surgical procedures performed with the DSAEK. Function of glaucoma filters may be affected after DSAEK, with 18% of eyes requiring additional medical therapy post-op, however no filters failed during the post-operative period. While these are difficult surgeries, posing multiple unique challenges, excellent outcomes comparable to those seen in less complex eyes can be achieved

Keywords: transplantation • cornea: endothelium • trabecular meshwork 
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