advertisement

---

1 General aspects (0)   1.1 Epidemiology (9)   1.2 Population genetics (2)   1.3 Pathogenesis (3)   1.4 Quality of life (16)   1.5 Glaucomas as cause of blindness (2)   1.6 Prevention and screening (11) 2 Anatomical structures in glaucoma (0)   2.1 Conjunctiva (5)   2.2 Cornea (13)   2.3 Sclera (5)   2.4 Anterior chamber angle (1)   2.5 Meshwork (0)     2.5.1 Trabecular meshwork (8)     2.5.2 Schlemms canal (2)     2.5.3 Scleral outlet channels (0)   2.6 Aqueous humor dynamics (0)     2.6.1 Production (0)     2.6.2 Outflow (1)       2.6.2.1 Trabecular meshwork (0)       2.6.2.2 Uveoscleral (0)     2.6.3 Compostion (3)   2.7 Episcleral veins and venous pressure (3)   2.8 Iris (4)   2.9 Ciliary body (0)   2.10 Lens (2)   2.11 Vitreous body (2)   2.12 Choroid, peripapillary choroid, peripapillary atrophy (10)   2.13 Retina and retinal nerve fibre layer (23)   2.14 Optic disc (31)   2.15 Optic nerve (5)   2.16 Chiasma and retrochiasmal central nervous system (4)   2.17 Stem cells (2)   2.20 Other (0) 3 Laboratory methods (0)   3.1 Microscopy (0)   3.2 Electron microscopy (0)   3.3 Immunohistochemistry (0)   3.4 Molecular genetics (0)     3.4.1 Linkage studies (0)     3.4.2 Gene studies (16)   3.5 Molecular biology incl. SiRNA (16)   3.6 Cellular biology (22)   3.7 Biochemistry (5)   3.8 Pharmacology (15)   3.9 Pathophysiology (9)   3.10 Immunobiology (5)   3.11 Pharmacogenetics (0)   3.12 Proteomics (1)   3.13 In vivo imaging (0)     3.13.1 Laser Scanning (0)       3.13.1.1 Confocal Scanning Laser Ophthalmoscopy (0)       3.13.1.2 Confocal Scanning Laser Polarimetry (0)     3.13.2 Optical Coherence Tomography (0)       3.13.2.1 Anterior Segment (0)       3.13.2.2 Posterior Segment (0)     3.13.3 RGC Imaging (0)     3.13.4 Other (1)   3.20 Other (0) 4 Tissue culture of ocular cells (0) 5 Experimental glaucoma; animal models (0)   5.1 Rodent (26)   5.2 Primates (0)   5.3 Other (2) 6 Clinical examination methods (0)   6.1 Intraocular pressure measurement; factors affecting IOP (0)     6.1.1 Devices, techniques (10)     6.1.2 Fluctuation, circadian rhythms (3)     6.1.3 Factors affecting IOP (15)   6.2 Tonography, aqueous flow measurement (see also 2.6) (0)   6.3 Biomicroscopy (slitlamp) (0)     6.3.1 Anterior segment (0)     6.3.2 Posterior segment (2)   6.4 Gonioscopy (2)   6.5 Ophthalmoscopy (1)   6.6 Visual field examination and other visual function tests (0)     6.6.1 Conventional manual (0)     6.6.2 Automated (24)     6.6.3 Special methods (e.g. color, contrast, SWAP etc.) (10)   6.7 Electro-ophthalmodiagnosis (3)   6.8 Photography (0)     6.8.1 Anterior segment (1)     6.8.2 Posterior segment (11)   6.9 Computerized image analysis (0)     6.9.1 Laser scanning (0)       6.9.1.1 Confocal Scanning Laser Ophthalmoscopy (1)       6.9.1.2 Confocal Scanning Laser Polarimetry (1)     6.9.2 Optical coherence tomography (0)       6.9.2.1 Anterior (4)       6.9.2.2 Posterior (49)     6.9.5 Other (11)   6.10 Fluorescein (ICG) angiography (0)     6.10.1 Anterior segment (0)     6.10.2 Posterior segment (0)   6.11 Bloodflow measurements (18)   6.12 Ultrasonography and ultrasound biomicroscopy (10)   6.13 Provocative tests (0)   6.19 Telemedicine (6)   6.20 Progression (13)   6.30 Other (7) 8 Refractive errors in relation to glaucoma (1)   8.1 Myopia (9)   8.2 Hypermetropia (0)   8.3 Contact lenses (0)   8.4 Refractive surgical procedures (1)   8.5 Other (1) 9 Clinical forms of glaucomas (0)   9.1 Developmental glaucomas (0)     9.1.1 Congenital glaucoma, Buphthalmos (12)     9.1.2 Juvenile glaucoma (16)     9.1.3 Syndromes of Axenfeld, Rieger, Peters, aniridia (1)     9.1.4 Other (1)   9.2 Primary open angle glaucomas (1)     9.2.1 Ocular hypertension (9)     9.2.2 Other risk factors for glaucoma (11)     9.2.3 Open angle glaucoma with elevated IOP (4)     9.2.4 Normal pressure glaucoma (17)   9.3 Primary angle closure glaucomas (0)     9.3.1 Acute primary angle closure glaucoma (pupillary block) (8)     9.3.2 Chronic primary angle closure glaucoma (pupillary block) (5)     9.3.3 Plateau iris syndrome (0)     9.3.4 Primary angle closure suspect (2)     9.3.5 Primary angle closure (7)     9.3.10 Other (0)   9.4 Glaucomas associated with other ocular and systemic disorders (1)     9.4.1 Steroid-induced glaucoma (6)     9.4.2 Glaucomas associated with disorders of the cornea, conjunctiva, sclera (0)       9.4.2.1 Iridocorneal endothelial syndrome (ICE, incl. irisatrophy) (1)       9.4.2.2 Posterior polymorphous dystrophy (0)       9.4.2.3 Fuchs' endothelial dystrophy (0)       9.4.2.5 Other (0)     9.4.3 Glaucomas associated with disorders of the iris and ciliary body (0)       9.4.3.1 Pigmentary glaucoma (4)       9.4.3.5 Other (0)     9.4.4 Glaucomas associated with disorders of the lens (0)       9.4.4.1 Exfoliation syndrome (6)       9.4.4.2 Glaucomas associated with cataracts (3)       9.4.4.3 Glaucomas associated with lens dislocation (1)       9.4.4.5 Other (1)     9.4.5 Glaucomas associated with disorders of the retina, choroid and vitreous (0)       9.4.5.1 Neovascular glaucoma (5)       9.4.5.5 Other (10)     9.4.6 Glaucomas associated with inflammation, uveitis (7)     9.4.7 Glaucomas associated with ocular trauma (1)     9.4.8 Glaucomas associated with intraocular tumors (2)     9.4.9 Glaucomas associated with elevated episcleral venous pressure (1)       9.4.10 Glaucomas associated with hemorrhage (3)     9.4.11 Glaucomas following intraocular surgery (0)       9.4.11.1 Ciliary block (malignant) glaucoma (2)       9.4.11.2 Glaucomas in aphakia and pseudophakia (5)       9.4.11.3 Epithelial, fibrous, and endothelial proliferation (0)       9.4.11.4 Glaucomas associated with corneal surgery (2)       9.4.11.5 Glaucomas associated with vitreoretinal surgery (3)     9.4.15 Glaucoma in relation to systemic disease (28)     9.4.20 Other (0) 10 Differential diagnosis e.g. anterior and posterior ischemic optic neuropathy (4) 11 Medical treatment (0)   11.1 General management, indication (3)   11.2 Cholinergic drugs (1)   11.3 Adrenergic drugs (0)     11.3.1 Epinephrine (0)     11.3.2 Thymoxamine, dapiprazole (0)     11.3.3 Apraclonidine, brimonidine (1)     11.3.4 Betablocker (4)     11.3.5 Other (0)   11.4 Prostaglandins (13)   11.5 Carbonic anhydrase inhibitors (1)     11.5.1 Systemic (1)     11.5.2 Topical (1)   11.6 Osmotic treatment (1)   11.7 Treatment of bloodflow (0)   11.8 Neuroprotection (28)   11.9 Gene therapy (1)   11.13 Combination therapy (0)     11.13.1 Betablocker and pilocarpine (0)     11.13.2 Betablocker and carbon anhydrase inhibitor (0)     11.13.3 Betablocker and brimonidine (1)     11.13.4 Betablocker and prostaglandin (2)     11.13.5 Other (1)   11.14 Investigational drugs; pharmacological experiments (8)   11.15 Other drugs in relation to glaucoma (16)   11.16 Vehicles, delivery systems, pharmacokinetics, formulation (16)   11.17 Cooperation with medical therapy e.g. persistency, compliance, adherence (6)   11.20 Other (0) 12 Surgical treatment (0)   12.1 General management, indication (3)   12.2 Laser iridotomy (3)   12.3 Laser iridoplasty (1)   12.4 Laser trabeculoplasty and other laser treatment of the angle (5)   12.7 Surgical iridectomy (0)   12.8 Filtering surgery (0)     12.8.1 Without tube implant (10)     12.8.2 With tube implant or other drainage devices (50)     12.8.3 Non-perforating (11)     12.8.4 Using laser (0)     12.8.5 Other (0)     12.8.10 Woundhealing antifibrosis (12)     12.8.11 Complications, endophthalmitis (10)   12.9 Trabeculotomy, goniotomy (11)   12.10 Cyclodestruction (9)   12.11 Cyclodialysis (0)   12.12 Cataract extraction (0)     12.12.1 Intracapsular (0)     12.12.2 Extracapsular (0)     12.12.3 Phacoemulsification (9)   12.14 Combined cataract extraction and glaucoma surgery (0)     12.14.1 Intracapsular (0)     12.14.2 Extracapsular (0)     12.14.3 Phacoemulsification (8)   12.15 Capsulotomy (0)   12.16 Vitrectomy (0)   12.17 Anesthesia (0)   12.20 Other (1) 13 Therapeutic prognosis and outcome (0)   13.1 Prognostic factors (2)   13.2 Outcome (0)     13.2.1 IOP (1)     13.2.2 Visual field (0)       13.2.2.1 Progression (0)       13.2.2.2 Improvement (0)     13.2.3 Other (0) 14 Costing studies; pharmacoeconomics (5) 15 Miscellaneous (23)

---

Abstract #79813 Published in IGR 20-2

Clinical Outcomes of Descemet Membrane Endothelial Keratoplasty in Eyes With a Glaucoma Drainage Device

Birbal RS; Tong CM; Dapena I; Parker JS; Parker JS; Oellerich S; Melles GRJ
American Journal of Ophthalmology 2019; 199: 150-158

---

PURPOSE: To evaluate the feasibility and clinical outcomes of Descemet membrane endothelial keratoplasty (DMEK) in eyes with a glaucoma drainage device (GDD). DESIGN: Retrospective, interventional case series. METHODS: Clinical outcomes of 23 DMEK procedures for bullous keratopathy (52%), failed previous transplant (39%), or Fuchs endothelial corneal dystrophy (9%) in 20 eyes (19 patients) with a GDD were retrospectively analyzed at 2 tertiary referral centers. Main outcome measures were best-corrected visual acuity (BCVA), endothelial cell density (ECD), postoperative complications, and graft survival. RESULTS: Mean length of postoperative follow-up after DMEK was 19 (±17) months. Kaplan-Meier survival analysis showed an 89% cumulative graft success rate at 1 year postoperatively. At 1 year postoperatively (n = 15 eyes), BCVA improved by ≥2 Snellen lines in 11 eyes (73%) and remained stable in 4 eyes (27%). Donor ECD decreased by 37% (n = 14), 60% (n = 11), and 71% (n = 11) at 1, 6, and 12 months postoperatively, respectively. Postoperative complications up to 2 years postoperatively comprised pupillary block in 1 eye (successfully reversed by partial air removal), visually significant graft detachment requiring rebubbling in 5 eyes (22%), allograft rejection successfully reversed with topical steroids in 2 eyes (9%), secondary graft failure in 2 eyes (9%), and cataract in 1 of 3 phakic eyes (33%). Re-keratoplasty was required in 2 eyes (9%). CONCLUSIONS: With specific surgical modifications, DMEK provided acceptable clinical outcomes when taking the complexity of these eyes into account. However, presence of a GDD may reduce graft survival times and may pose a risk for more frequent regrafting.

Netherlands Institute for Innovative Ocular Surgery (NIIOS), Rotterdam, Netherlands; Melles Cornea Clinic Rotterdam, Rotterdam, Netherlands; Amnitrans EyeBank Rotterdam, Rotterdam, Netherlands.

Full article

---

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)
2.2 Cornea (Part of: 2 Anatomical structures in glaucoma)

---

• ← Previous
• Next →

---