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Glaucoma associated with DSAEK failure
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COEUR D’ALENE, Idaho — Glaucoma was strongly associated with higher failure rates after Descemet’s stripping automated endothelial keratoplasty, according to a poster presented at the Women in Ophthalmology Summer Symposium.
In a 7-year retrospective chart review, Jefferson Berryman, MD, and colleagues at University of California, Davis, reported an overall failure rate of 17% in 241 eyes that underwent DSAEK performed by a single surgeon; 116 of those eyes were diagnosed previously with glaucoma or ocular hypertension. DSAEK failed in 38 of the glaucomatous eyes (32.8%; P < .0001), whereas only three failures were recorded in eyes without glaucoma (2.4%).
Statistically significantly greater risk for failure was identified in eyes with chronic angle closure (P < .0001), primary open-angle glaucoma (P < .0001) and juvenile open-angle glaucoma (P < .0004).
In eyes that had undergone previous glaucoma surgery, multivariate analysis showed increased risk for failure only in eyes implanted with a glaucoma drainage device.
Twelve eyes required re-bubbling after early graft failure. Postoperative hypotony was found to be the only associated risk factor.
Mean patient age was 68.5 years, mean follow-up was 2.94 years, and mean postoperative best corrected visual acuity was 0.588 logMAR. Patients with follow-up length less than 6 months following surgery were excluded from the analysis.
Regarding medications, “Only beta-blockers were found to increase failure rates for unknown reasons. Other IOP-lowering medication classes had no effect,” the authors wrote. – by Eamon Dreisbach
Reference:
Berryman J, et al. DSAEK survival in eyes with pre-existing glaucoma. Presented at: Women in Ophthalmology Summer Symposium; Aug. 22-25, 2019; Coeur d’Alene, Idaho.
Disclosures: The authors report no relevant financial disclosures.