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Abstract #94440 Published in IGR 22-2

Corneal transplant survival rate in glaucoma patients with multiple previous antiglaucoma surgeries

Fili S; Kontopoulou K; Bechrakis N; Kohlhaas M
International Ophthalmology 2021; 41: 3387-3399

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BACKGROUND: Glaucoma can cause corneal decompensation and accelerate the failure of the graft. Previous antiglaucoma operations are one of the most important risk factors for endothelial failure. METHODS: In this retrospective study, 40 eyes of 40 glaucoma patients with advanced corneal decompensation after glaucoma surgery were treated with keratoplasty and outcomes were assessed for 24 months. RESULTS: 16, 9 and 15 eyes underwent Descemet Membrane Endothelial Keratoplasty (DMEK), Descemet's Stripping Automated Endothelial Keratoplasty (DSAEK) and penetrating keratoplasty (pKPL), respectively. Visual acuity improved at least 2 lines in 24 of 40 eyes after the three types of keratoplasty. All 40 eyes remained pain free for the follow-up period. The mean intraocular pressure (IOP) difference was not significantly different (p > 0.05) from the preoperative values 12 and 24 months after keratoplasty. The endothelial cell density of the donor cornea decreased from 2485.6 ± 165.18 to 1291.4 ± 467.1 and 1180.4 ± 397.2/mm (p < 0.001) after 12 and 24 months, respectively. Nine eyes (22.5%) had therapy-resistant corneal decompensation in the context of a transplant failure and were treated with a re-keratoplasty (2 re-pKPLs, 3 re-DSAEKs and 3 re-DMEKs). CONCLUSIONS: Eyes with previous glaucoma surgery show satisfying results after keratoplasty, mainly DMEK and pKPL.

Department of Ophthalmology, Clinic of Ophthalmology, St. Johannes Hospital, Johannesstraße 9-13, 44137, Dortmund, Germany. sofia.fili@joho-dortmund.de.

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)

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