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

Chiam, Patrick J, Cheeseman, Robert, Ho, Vivian W, Romano, Vito ORCID: 0000-0002-5148-7643, Choudhary, Anshoo, Batterbury, Mark, Kaye, Stephen B ORCID: 0000-0003-0390-0592 and Willoughby, Colin E (2017) Outcome of Descemet stripping automated endothelial keratoplasty in eyes with an Ahmed glaucoma valve. GRAEFES ARCHIVE FOR CLINICAL AND EXPERIMENTAL OPHTHALMOLOGY, 255 (5). pp. 987-993.

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Abstract

<h4>Purpose</h4>The purpose was to investigate the survival of Descemet stripping automated endothelial keratoplasty (DSAEK) in eyes with an Ahmed glaucoma valve (AGV).<h4>Methods</h4>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.<h4>Results</h4>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).<h4>Conclusion</h4>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.

Item Type:	Article
Uncontrolled Keywords:	Descemet stripping automated endothelial keratoplasty, DSAEK, Endothelial keratoplasty, Ahmed glaucoma valve, AGV, Glaucoma drainage device, Graft survival
Depositing User:	Symplectic Admin
Date Deposited:	14 Mar 2018 10:26
Last Modified:	19 Jan 2023 06:38
DOI:	10.1007/s00417-017-3612-2
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3019000