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Abstract #49139 Published in IGR 14-1
Graft Dislocation and Hypotony after Descemet's Stripping Automated Endothelial Keratoplasty in Patients with Previous Glaucoma Surgery
Goshe JM; Terry MA; Li JY; Straiko MD; Davis-Boozer DOphthalmology 2012; 119: 1130-1133
PURPOSE: To determine if patients with prior glaucoma surgery experience higher rates of postoperative graft dislocation after Descemet's stripping automated endothelial keratoplasty (DSAEK) and to determine if postoperative hypotony may be a risk factor in these patients. DESIGN: Retrospective, comparative analysis of an interventional case series. PARTICIPANTS: Eight hundred fifty-four eyes (67 eyes with prior glaucoma surgery and 787 controls) from 582 patients who underwent DSAEK at 1 institution between January 2005 and April 2011. METHODS: Groups were compared with regard to preoperative, intraoperative, and postoperative parameters. Continuous variables were compared using the independent samples t test or Mann-Whitney U test. Categorical variables were compared using the chi-square test or Fisher exact test. MAIN OUTCOME MEASURES: Frequencies of postoperative graft dislocation and postoperative hypotony. RESULTS: Study eyes before surgery differed from control eyes with regard to corneal thickness (768 vs. 655 μm; P<0.001) and intraocular pressure (13 vs. 16 mmHg; P<0.001). Postoperative graft dislocation occurred significantly more frequently in study eyes compared with control eyes (9% vs. 2%; P = 0.008). Among eyes in which dislocation occurred, postoperative hypotony was present in 5 study eyes (83%) and 0 control eyes. CONCLUSIONS: Previous glaucoma surgery was associated with a significantly increased rate of graft dislocation compared with control eyes. Dislocation was related strongly to postoperative hypotony in eyes with prior glaucoma surgery. FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found after the references.
Devers Eye Institute, Portland, OR, USA.
Full articleClassification:
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)