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Abstract #60452 Published in IGR 16-4

Nonpenetrating deep sclerectomy for glaucoma after descemet stripping automated endothelial keratoplasty: three consecutive case reports

Muñoz-Negrete FJ; Arnalich-Montiel F; Casado A; Rebolleda G
Medicine 2015; 94: e543

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The purpose of this study was to evaluate the efficacy and safety of nonpenetrating deep sclerectomy (NPDS) in 3 consecutive eyes with preexisting and uncontrolled glaucoma after Descemet stripping with automated endothelial keratoplasty (DSAEK).NPDS with intrascleral implant and topical adjunctive intraoperative mitomycin C (0.2 mg/mL 1 minute) was performed.Intraocular pressure (IOP) and number of glaucoma medication were registered before and after NPDS with at least 1-year follow-up. Intraoperative and postoperative complications were also registered.Before NPDS, IOP was 18 mm Hg in 1 patient and 32 mm Hg in the other 2 patients. Four antiglaucoma drugs were used in 2 cases and 3 in the other one. At 1 year after NPDS, all the patients had an IOP ≤18 mm Hg. Two patients required postoperative antiglaucoma medications (1 drug in 1 case and 2 drugs in the other one). Neodymium-doped yttrium aluminum garnet laser goniopuncture was needed in 2 patients and it had to be repeated in 1 of them. No complications related to NPDS were observed. A corneal graft rejection was observed 5 months after NPDS in 1 case that resolved without sequelae with intensive corticosteroid eye-drop therapy.NPDS could be a safe and successful alternative to conventional filtration surgery after DSAEK in eyes with uncontrolled glaucoma. Larger series and a longer follow-up would be necessary to set the actual role of surgery in DSAEK patients.

From the Ophthalmology Department, Ramon y Cajal University Hospital, IRYCIS, University of Alcala, 28034 Madrid, Spain.

Full article

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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)
12.8.3 Non-perforating (Part of: 12 Surgical treatment > 12.8 Filtering surgery)

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