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Abstract #27383 Published in IGR 12-4
Evaluation of Ex-PRESS mini glaucoma shunt implantation in refractory postpenetrating keratoplasty glaucoma
Ates H; Palamar M; Yagci A; Egrilmez SJournal of Glaucoma 2010; 19: 556-560
Purpose: To evaluate the intraocular pressure (IOP) control and graft survival after Ex-PRESS mini glaucoma shunt implantation in refractory postpenetrating keratoplasty glaucoma. Methods: The study included postpenetrating keratoplasty glaucoma cases unresponsive to medical antiglaucomatous therapy in whom 15 Ex-PRESS mini glaucoma shunt implantation was carried out. All glaucoma shunt implantations were performed in a separate session after penetrating keratoplasty. Nine operations were performed under general anesthesia and 6 were performed under local anesthesia. Topical antibiotherapy and topical corticosteroids were used during the postoperative first month. Results: Mean age of the study population was 37.4 years (range: 10 to 80 y). IOP decreased from 41.46 mm Hg (range: 26 to 80 mm Hg) to 12.06 mm Hg (range: 8 to 25 mm Hg) over a mean follow-up of 12.2 months (range: 8 to 19 mo) (P<0.001; Wilcoxon signed rank test). IOP was below 21 mm Hg in 14 of 15 eyes (93.3%) with or without antiglaucomatous drugs. Complete success (IOP<21 mm Hg without medication) rate was 86.6%. Average number of antiglaucomatous drug usage decreased from 3.20 (range: 2 to 4) preoperatively to 0.26 postoperatively (range: 0 to 3) (P<0.001; Wilcoxon signed rank test). In 93.3% of the cases, the decrease in IOP was 30% or above postoperatively. After Ex-PRESS implantation, clear grafts remained clear while edematous grafts became clearer due to IOP decrease. Neither biomicroscopy nor pachymetry showed worsening of preoperatively opaque grafts. Conclusion: Ex-PRESS mini glaucoma shunt implantation may be an effective procedure for refractory postpenetrating keratoplasty glaucoma with acceptable graft failure rates in short term. Copyright (copyright) 2010 by Lippincott Williams & Wilkins.
M. Palamar. Department of Ophthalmology, Ege University Faculty of Medicine, Bornova, Izmir 35040, Turkey. melispalamar@hotmail.com
Classification:
12.8.2 With tube implant or other drainage devices (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
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)
