Outcomes of Descemet Stripping Endothelial Keratoplasty in Eyes With Pars Plana Versus Anterior Chamber Glaucoma Drainage Devices
| Autor: | Kevin Lai, Ruth Eisenberg, John A. Seedor, Joann J. Kang, Jeffrey M. Liebmann, David C. Rittterband |
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| Rok vydání: | 2019 |
| Předmět: |
Male
Pars plana Intraocular pressure medicine.medical_specialty Visual acuity genetic structures Anterior Chamber medicine.medical_treatment Visual Acuity Glaucoma Trabeculectomy Corneal Diseases Interquartile range Ophthalmology medicine Glaucoma surgery Humans Glaucoma Drainage Implants Intraocular Pressure Aged Retrospective Studies business.industry Graft Survival Retrospective cohort study medicine.disease eye diseases Treatment Outcome medicine.anatomical_structure Descemet Stripping Endothelial Keratoplasty Female medicine.symptom business Follow-Up Studies |
| Zdroj: | Cornea. 38:1364-1369 |
| ISSN: | 0277-3740 |
| DOI: | 10.1097/ico.0000000000002059 |
| Popis: | Purpose To compare visual outcomes and complications of Descemet stripping endothelial keratoplasty (DSEK) in eyes with anterior chamber (AC) versus pars plana (PP) glaucoma drainage devices (GDDs). Methods A retrospective chart review was conducted of 85 eyes that underwent DSEK and had previous or concurrent AC (37 eyes) or PP (48 eyes) GDD implantation. Outcome measures examined included visual acuity, donor dislocation rate, intraocular pressure, and secondary graft failure (SGF). Results The mean logarithm of the minimum angle of resolution vision improved from 1.50 (SD = 0.64) to 0.88 (SD = 0.71) in the AC group and from 1.37 (SD = 0.59) to 1.20 (SD = 0.76) in the PP group, with no significant group difference. Intraocular pressure did not differ between the groups preoperatively but was higher in the AC group compared with the PP group postoperatively [mean (SD) 14.5 (6.28) versus 11.5 (5.54) mm Hg, P = 0.03]. Graft dislocation occurred in 35.1% and 29.2% of eyes in the AC and PP groups, respectively. SGF occurred in 18.9% and 41.7% with median time 17.1 (interquartile range [IQR] 4.6-32.1) and 27.9 (IQR 15.1-34.7) months to development in the AC and PP groups, respectively. Multivariable logistic and Cox proportional hazards regression models found no statistically significant factors (tube location, age, sex, concurrent tube revision, new tube insertion) associated with either donor dislocation or SGF. Conclusions There was no reduction in donor dislocation or SGF in eyes with PP compared with AC GDD, despite the decreased proximity of the shunt from the endothelial graft. Overall, GDD has a significantly adverse effect on long-term graft survival and close follow-up is warranted. |
| Databáze: | OpenAIRE |
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