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No increased risk of IOP elevation after DSAEK in glaucoma patients
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KIAWAH ISLAND, S.C. — There is no increased risk of IOP elevation in patients with glaucoma who undergo Descemet's stripping automated endothelial keratoplasty, according to a study presented here.
In a retrospective chart review of 115 eyes with at least 18 months of follow-up, no statistically significant difference in median IOP was noted in 27 patients who underwent DSAEK and had a diagnosis of glaucoma when compared with 88 patients who underwent DSAEK but did not have a diagnosis of glaucoma.
There were more complications in the control group, predominantly graft dislocation. According to John W. French, MD, speaking at Kiawah Eye 2009, the higher rate of complications may be attributable to the steep learning curve associated with DSAEK, as the review included the first cases of three separate surgeons.
After surgery, four patients in the glaucoma group required additional medication to control elevated IOP compared with eight in the control group. In addition, four patients required an additional surgical procedure to treat elevated IOP. Of those, three had a history of glaucoma surgery.
"It appears that patients with a prior glaucoma surgery are at greatest risk for additional glaucoma surgery to control elevated IOP after DSAEK," Dr. French said.
The study did not compare change in IOP from baseline to the postsurgical period, he said.
Kiawah Eye 2010 will be held May 13-15, 2010 at the Kiawah Island Golf Resort in South Carolina. Learn more at KiawahEye.com.