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Abstract #18399 Published in IGR 3-3
Corneal graft survival and intraocular pressure control after penetrating keratoplasty and glaucoma drainage device implantation
Arroyave CP; Scott IU; Fantes FE; Feuer WJ; Murray TGOphthalmology 2001; 108: 1978-1985
OBJECTIVE: To investigate corneal graft survival rates and intraocular pressure (IOP) control in eyes after penetrating keratoplasty (PK) and glaucoma drainage device (GDD) implantation. DESIGN: Retrospective, comparative, consecutive case series. PARTICIPANTS: All patients who underwent PK and GDD implantation at the Bascom Palmer Eye Institute between Janaury 1st, 1993 and October 31st, 1998. MAIN OUTCOME MEASURES: Graft clarity and IOP control. RESULTS: Of the 72 eyes identified in 72 patients, 47 (65%) underwent combined PK and GDD implantation, and 25 (35%) underwent GDD placement after PK (2-30 months after PK; median, 13 months). The GDD type was Baerveldt 350 mm2 in 57 eyes, Ahmed in nine, Krupin in two, and other in four. The GDD was placed in the anterior chamber in 54 eyes (75%) and in the vitreous cavity in 18 (25%). Preoperative IOP was 11-53 mmHg with or without antiglaucoma medication in 16 eyes (30%) with the GDD implanted in the anterior chamber, and in four (22%) with the GDD placed in the vitreous cavity (p = 0.76). At one year after GDD implantation, the graft was clear in 26 eyes (48%) with the GDD in the anterior chamber compared with 15 eyes (83%) with the GDD in the vitreous cavity (p = 0.013). Forty-eight eyes (89%) with the GDD in the anterior chamber and 18 (100%) with the GDD in the vitreous cavity had IOP between 5 and 21 mmHg with or without antiglaucoma medication (p = 0.33). The mean reduction in IOP, one year after surgery, was 12 mmHg in eyes with the GDD in the anterior chamber, compared with 17 mmHg in eyes with the GDD in the vitreous cavity (p = 0.13). CONCLUSIONS: Corneal graft survival at one year is significantly higher in eyes with the GDD implanted in the vitreous cavity compared to those with the GDD implanted in the anterior chamber. IOP was significantly lower at one year after surgery compared to that before surgery in both groups, and there was no significant difference between the groups in IOP control and amount of IOP reduction. There was no significant difference in corneal graft survival or IOP control between eyes with the GDD implanted concurrently with PK versus after PK.
Dr I.U. Scott, Bascom Palmer Eye Institute, P.O. Box 016880, Miami, FL 33101, USA. iscott@bpei.med.miami.edu
Classification:
9.4.11.4 Glaucomas associated with corneal surgery (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders > 9.4.11 Glaucomas following intraocular surgery)
