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. 2012 Dec;21(9):608-14.
doi: 10.1097/IJG.0b013e31821db3e5.

Five-year outcomes of eyes with glaucoma drainage device and penetrating keratoplasty

Robert M Knape  1 , Tiffany N Szymarek, Sonal S Tuli, William T Driebe, Mark B Sherwood, Mary Fran Smith
Affiliations

Five-year outcomes of eyes with glaucoma drainage device and penetrating keratoplasty

Robert M Knape et al. J Glaucoma. 2012 Dec.

Abstract

Purpose: To investigate intraocular pressure (IOP) control and corneal graft survival rates in eyes with glaucoma drainage device (GDD) implantation and penetrating keratoplasty (PK) and 5 years of follow-up data.

Design: Retrospective review.

Methods: We performed a review of records of all patients who underwent both GDD placement and PK at our institution between January 1, 1988 and December 31, 2003. Twenty-eight eyes of 27 patients were studied. Glaucoma outcome was assessed by postoperative IOP, number of glaucoma medications, and need for further glaucoma surgery. Corneal grafts were assessed for clarity.

Results: All eyes had GDD placement in the anterior chamber. The mean pre-GDD IOP was 28.8 ± 10.3 mm Hg on a mean of 2.6 ± 0.8 glaucoma medications. At 5-year follow-up, the mean IOP was 13.0 ± 5.9 mm Hg on a mean of 0.9 ± 1.0 glaucoma medications. GDD implantation successfully controlled glaucoma in 96%, 86%, 79%, 75%, and 71% of eyes at 1, 2, 3, 4, and 5 years, respectively. Grafts remained clear in 96%, 82%, 75%, 57%, and 54% of eyes at 1, 2, 3, 4, and 5 years, respectively. Failure of glaucoma outcome or graft survival was associated with prior intraocular surgeries.

Conclusions: Our data suggests that GDD placement can provide glaucoma control in a high percentage (71%) of eyes with PK even at 5 years. Furthermore, the success of PK in eyes with GDD remains reasonable (54%) at 5 years. IOP control and graft survival rates are comparable with earlier published studies with shorter follow-up or tube placement in the vitreous cavity.

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Conflict of interest statement

Disclosure: The authors declare no conflict of interest.

Figures

FIGURE 1
FIGURE 1
Scatter plot of pre-glaucoma drainage device (GDD) and 5-year follow-up intraocular pressure (IOP).
FIGURE 2
FIGURE 2
Number of pre-glaucoma drainage device (GDD) and 5-year follow-up medications.
FIGURE 3
FIGURE 3
Overall Kaplan-Meier survival curve of glaucoma success. IOP indicates intraocular pressure.
FIGURE 4
FIGURE 4
Overall Kaplan-Meier survival curve of penetrating keratoplasty (PK) success.
FIGURE 5
FIGURE 5
Overall Kaplan-Meier survival curve of glaucoma (intraocular pressure ≤ 18 mm Hg) and graft success. PK indicates penetrating keratoplasty.
See this image and copyright information in PMC

References

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