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Abstract #45997 Published in IGR 13-2
Five-year outcomes of eyes with glaucoma drainage device and penetrating keratoplasty
Knape RM; Szymarek TN; Tuli SS; Driebe WT; Sherwood MB; Smith MFJournal of Glaucoma 2011;
PURPOSE: To investigate intraocular pressure (IOP) control and corneal graft survival rates in eyes with glaucoma drainage device (GDD) implantation and penetrating keratoplasty (PK) and 5 years of follow-up data. DESIGN: Retrospective review. METHODS: We performed a review of records of all patients who underwent both GDD placement and PK at our institution between January 1, 1988 and December 31, 2003. Twenty-eight eyes of 27 patients were studied. Glaucoma outcome was assessed by postoperative IOP, number of glaucoma medications, and need for further glaucoma surgery. Corneal grafts were assessed for clarity. RESULTS: All eyes had GDD placement in the anterior chamber. The mean pre-GDD IOP was 28.8(plus or minus)10.3 mm Hg on a mean of 2.6(plus or minus)0.8 glaucoma medications. At 5-year follow-up, the mean IOP was 13.0(plus or minus)5.9 mm Hg on a mean of 0.9(plus or minus)1.0 glaucoma medications. GDD implantation successfully controlled glaucoma in 96%, 86%, 79%, 75%, and 71% of eyes at 1, 2, 3, 4, and 5 years, respectively. Grafts remained clear in 96%, 82%, 75%, 57%, and 54% of eyes at 1, 2, 3, 4, and 5 years, respectively. Failure of glaucoma outcome or graft survival was associated with prior intraocular surgeries. CONCLUSIONS: Our data suggests that GDD placement can provide glaucoma control in a high percentage (71%) of eyes with PK even at 5 years. Furthermore, the success of PK in eyes with GDD remains reasonable (54%) at 5 years. IOP control and graft survival rates are comparable with earlier published studies with shorter follow-up or tube placement in the vitreous cavity.
R. M. Knape.
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)
