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

    4 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.
    LanguageEnglish
    Pages987-993
    JournalGraefe's Archive for Clinical and Experimental Ophthalmology
    Volume255
    Issue number5
    DOIs
    Publication statusAccepted/In press - 6 Feb 2017

    Fingerprint

    Descemet Stripping Endothelial Keratoplasty
    Glaucoma
    Transplants
    Intraocular Pressure
    Anterior Chamber
    Survival Rate
    Age Factors
    Graft Survival
    Linear Models
    Endothelial Cells
    Cell Count
    Logistic Models
    Tissue Donors

    Keywords

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

    Cite this

    Chiam, Patrick J ; Cheeseman, Robert ; Ho, Vivian W ; Romano, Vito ; Choudhary, Anshoo ; Batterbury, Mark ; Kaye, Stephen B ; Willoughby, Colin. / Outcome of Descemet stripping automated endothelial keratoplasty in eyes with an Ahmed glaucoma valve. In: Graefe's Archive for Clinical and Experimental Ophthalmology. 2017 ; Vol. 255, No. 5. pp. 987-993.
    @article{236e999726be45e89cfb706fb252f127,
    title = "Outcome of Descemet stripping automated endothelial keratoplasty in eyes with an Ahmed glaucoma valve",
    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.",
    keywords = "AGV, Ahmed glaucoma valve, DSAEK, Descemet stripping automated endothelial keratoplasty, Endothelial keratoplasty, Glaucoma drainage device, Graft survival",
    author = "Chiam, {Patrick J} and Robert Cheeseman and Ho, {Vivian W} and Vito Romano and Anshoo Choudhary and Mark Batterbury and Kaye, {Stephen B} and Colin Willoughby",
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    Outcome of Descemet stripping automated endothelial keratoplasty in eyes with an Ahmed glaucoma valve. / Chiam, Patrick J; Cheeseman, Robert; Ho, Vivian W; Romano, Vito; Choudhary, Anshoo; Batterbury, Mark; Kaye, Stephen B; Willoughby, Colin.

    In: Graefe's Archive for Clinical and Experimental Ophthalmology, Vol. 255, No. 5, 06.02.2017, p. 987-993.

    Research output: Contribution to journalArticle

    TY - JOUR

    T1 - Outcome of Descemet stripping automated endothelial keratoplasty in eyes with an Ahmed glaucoma valve

    AU - Chiam, Patrick J

    AU - Cheeseman, Robert

    AU - Ho, Vivian W

    AU - Romano, Vito

    AU - Choudhary, Anshoo

    AU - Batterbury, Mark

    AU - Kaye, Stephen B

    AU - Willoughby, Colin

    PY - 2017/2/6

    Y1 - 2017/2/6

    N2 - 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.

    AB - 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.

    KW - AGV

    KW - Ahmed glaucoma valve

    KW - DSAEK

    KW - Descemet stripping automated endothelial keratoplasty

    KW - Endothelial keratoplasty

    KW - Glaucoma drainage device

    KW - Graft survival

    U2 - 10.1007/s00417-017-3612-2

    DO - 10.1007/s00417-017-3612-2

    M3 - Article

    VL - 255

    SP - 987

    EP - 993

    JO - Graefe's Archive for Clinical and Experimental Ophthalmology

    T2 - Graefe's Archive for Clinical and Experimental Ophthalmology

    JF - Graefe's Archive for Clinical and Experimental Ophthalmology

    SN - 0721-832X

    IS - 5

    ER -