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Abstract #45980 Published in IGR 13-2
Double use of corneal graft for descemet stripping automated endothelial keratoplasty and coverage of glaucoma drainage device tube
Spierer O; Rachmiel R; Lazar M; Alba M; Varssano DJournal of Glaucoma 2011;
PURPOSE: To describe the efficacy and safety of using a single corneal graft for 2 different ocular surgeries, Descemet stripping automated endothelial keratoplasty in one patient and coverage of a glaucoma drainage device tube in another patient. MATERIALS AND METHODS: The records of 12 consecutive patients who underwent Ahmed glaucoma valve implantation using the anterior lamella of a donor cornea that had been previously used for Descemet stripping automated endothelial keratoplasty were reviewed. RESULTS: Nine eyes (75%) had superotemporal Ahmed valve implantation and 3 eyes (25%) had inferotemporal implantation. No intraoperative complications were encountered in any of these cases. During postoperative follow-up there were no graft rejections, wound dehiscences, tube exposures, or any glaucoma drainage device-related complications. In 1 patient, graft thinning was noticed 12 months after surgery, but without erosion of the conjunctiva or exposure of the tube. Mean intraocular pressure (IOP) before surgery was 32.8(plus or minus)9.3 mm Hg. The mean postoperative IOPs were 13.2(plus or minus)6.8 mm Hg (P<0.001) at day 1, 10.5(plus or minus)2.7 (P<0.001) at week 1, 12.2(plus or minus)3.5 (P<0.001) at month 1, 12.9(plus or minus)3.0 (P<0.001) at month 3, 14.2(plus or minus)7.0 (P<0.001) at month 6, and 13.0(plus or minus)6.4 (P<0.001) at the final visit. The mean reduction in IOP was 59%. Mean follow-up time after surgery was 21.7(plus or minus)7.5 months. CONCLUSIONS: The use of the anterior corneal graft cap for patching a tube is safe and effective. The double use of a corneal graft is economically worthwhile and especially useful in countries where there is shortage of donor corneal tissues.
O. Spierer.
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)
