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DSEK may improve vision in eyes with previous glaucoma surgery
Cornea. 2011;30(12):1304-1311.
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Descemet's stripping endothelial keratoplasty is a viable option for patients with advanced glaucoma and previous trabeculectomy and/or tube shunt implantation, according to a study.
In a retrospective review of 227 patients, researchers evaluated the incidence of intraoperative and postoperative complications and visual outcomes after DSEK in eyes that had prior penetrating glaucoma surgery. Fifty-six DSEK procedures were performed in 52 eyes with previous trabeculectomy and/or tube shunt implantation. Two surgeons from a single institution performed all procedures.
Postoperative complications were not significantly increased in eyes with a history of glaucoma surgery prior to DSEK.
There was no statistically significant difference in the percentage of procedures performed in eyes with and without a history of penetrating glaucoma surgery that resulted in primary graft failure (5.4% vs. 4.1%) or donor dislocation (12.5% vs. 15.2%).
Endothelial rejection rate was also not significantly different according to history of glaucoma surgery.
The rate of elevated IOP of at least 25 mm Hg after DSEK was highest in patients with medically controlled glaucoma (47.4%) and lowest in patients with prior glaucoma surgery (11.5%), according to the study.
"Because almost 50% of eyes with medically controlled glaucoma before DSEK experienced IOP elevation after surgery, careful monitoring of the IOP after DSEK is especially important in this patient population," the study authors said.