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Combined keratoplasty, glaucoma valve implant had low success rate in study

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The long-term success of simultaneous Ahmed glaucoma valve implant and penetrating keratoplasty in refractory congenital glaucoma associated with corneal opacity is low, and the complication rate is high, according to a retrospective study.

Abdullah A. Al-Torbak, MD, FRCS, of Saudi Arabia reviewed the charts of 20 eyes of 17 pediatric patients who had undergone the procedures simultaneously. Cumulative probabilities of success for IOP control after 2 months was 85%; after 24 months, 44%; and after 48 months, 33%. Probability of graft success after 2 months was 85%; after 24 months, 43%; and after 48 months, 17%.

Subconjunctival scarring, resulting in loss of long-term IOP control, was the most common cause of glaucoma-related failure that required subsequent surgery. The most common graft-related complications were graft failure (65%) and graft ulceration (30%). In four of the six ulcerated grafts, Streptococcus pneumoniae was cultured positively.

The study is published in the August issue of Cornea.