Outcome of Descemet stripping automated endothelial keratoplasty in eyes with an Ahmed glaucoma valve

Patrick J Chiam, Robert Cheeseman, Vivian W Ho, Vito Romano, Anshoo Choudhary, Mark Batterbury, Stephen B Kaye, Colin Willoughby

    Research output: Contribution to journalArticle

    5 Citations (Scopus)

    Abstract

    AbstractPURPOSE:The purpose was to investigate the survival of Descemet stripping automated endothelial keratoplasty (DSAEK) in eyes with an Ahmed glaucoma valve (AGV).METHODS:The study had a retrospective case-series of patients with an AGV in the anterior chamber undergoing a DSAEK. Included in the analysis were graft size, number of previous operations, post-operative glaucoma medications, post-operative intraocular pressure (IOP) control, graft size and donor factors (age, endothelial cell density, and post-mortem time). A generalised linear model with binary logistic regression was used to test for an effect on graft survival at 1 year and 1.5 years.RESULTS:Fourteen eyes from 13 patients were included. The survival rate of the first DSAEK at 6, 12, 18, 24 and 30-months was 85%, 71%, 50%, 36% and 30%, respectively. The mean duration to graft failure was 12.9 ± 6.2 months. Five of the seven failed first grafts went on to have a repeat DSAEK. The mean follow-up in this subgroup was 30.7 ± 18.4 months. The survival rate of second DSAEK at 6, 12, 18 and 24 months was 100% (5/5), 100% (5/5), 75% (3/4) and 67% (2/3). Only one second DSAEK failed in the duration of the study and went on to receive a third DSAEK which failed at 18-months. The mean IOP within the first year was significantly lower for grafts that survived at 1 and 1.5 years (17.4 mmHg, 16.9 mmHg) than for grafts that failed (19.4 mmHg, 19.4 mmHg) (p = 0.04, p = 0.009).CONCLUSION:DSAEK is a viable alternative to PK to restore visual function in eyes with an AGV sited in the anterior chamber. IOP is an important risk factor for graft failure.
    Original languageEnglish
    Pages (from-to)987-993
    JournalGraefe's Archive for Clinical and Experimental Ophthalmology
    Volume255
    Issue number5
    DOIs
    Publication statusAccepted/In press - 6 Feb 2017

    Keywords

    • AGV
    • Ahmed glaucoma valve
    • DSAEK
    • Descemet stripping automated endothelial keratoplasty
    • Endothelial keratoplasty
    • Glaucoma drainage device
    • Graft survival

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