PK, glaucoma drainage device may control short- and intermediate-term IOP

Pars plana implantation of a glaucoma drainage device mitigated IOP in eyes that underwent concurrent penetrating keratoplasty, a study found.

The study authors assessed corneal graft survival and IOP control after PK and Ahmed glaucoma valve (AGV, New World Medical) insertion in patients with glaucoma and corneal pathology.

“Pars plana AGV can successfully control IOP in PK patients in the short and intermediate terms, but graft clarity and IOP control diminish over time,” the authors said. “Graft decompensation, when it did occur, likely reflects the associated ocular morbidity and clinical complexity of this circumscribed cohort of eyes.”

The retrospective analysis included 25 eyes of 24 patients with a mean age of 79 years who underwent PK and pars plana AGV insertion.

Eighteen eyes underwent simultaneous AGV placement and PK. The remaining seven eyes underwent AGV placement a mean 84.1 days before PK.

Mean follow-up was 23 months. Mean follow-up for eyes that had both successful IOP control and clear corneal grafts was 12 months.

Study results showed that 89% of grafts survived at 1 year and 63% survived at 2 years. IOP was controlled in 78% of eyes at 1 year and 44% at 2 years.

At final follow-up, best corrected visual acuity improved by at least one line in 13 eyes (52%). Data showed that preoperative factors such as peripheral anterior synechiae were not associated with graft survival, IOP control or visual acuity at 1 year, the authors said.