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Previous glaucoma surgery not a contraindication for DSEK
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BOSTON — Descemet's stripping endothelial keratoplasty in patients with previous glaucoma surgery is associated with similar visual outcomes as patients without a history of glaucoma surgery, according to a speaker.
 Olivia Lee |
In a study of 227 consecutive DSEK cases, 56 of whom had previously undergone trabeculectomy or tube shunt implantation and 21 patients with medically controlled glaucoma, there was no significant difference in postoperative complications when patients were stratified by glaucoma history, Olivia Lee, MD, said at the World Cornea Congress preceding the American Society of Cataract and Refractive Surgery meeting.
At final follow-up, 85% of patients had improvement in corrected distance visual acuity; 79% of patients previously surgically treated for glaucoma had improvement and 87% of patients with no previous glaucoma surgery had visual improvement.
Overall, 19.2% of patients had a postoperative IOP reading of 25 mm Hg or greater during follow-up. A lower percentage of patients previously surgically treated for glaucoma (11.5%) had a postoperative IOP greater than 25 mm Hg than patients with no history of glaucoma surgery (21.7%).
However, Dr. Lee said, 47.3% of patients medically treated for glaucoma had IOP elevation greater than 25 mm Hg, "suggesting need to closely monitor IOP in these patients," Dr. Lee said.
Dr. Lee’s findings reflect my anecdotal experience with DSEK. I have had many patients with glaucoma who benefited from the procedure. I am a glaucoma specialist, so I would not feel comfortable commenting further on the indications for DSEK. However, I was very pleased to see that the results are good.
– Douglas J. Rhee, MD
OSN Glaucoma Board
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