Purpose: To compare the outcomes of trabeculectomy surgery after Descemet stripping automated endothelial keratoplasty (DSAEK) to penetrating keratoplasty (PK).
Design: Retrospective case-control study.
Methods: Patients within an institutional setting who underwent trabeculectomy with mitomycin C (MMC) for uncontrolled elevated intraocular pressure (IOP) after corneal graft surgery were included. Patients with pre-existing glaucoma were excluded. Twenty patients with trabeculectomy after DSAEK and 41 patients with trabeculectomy after PK were analyzed. The main outcome measure was IOP control at 12 months. Secondary outcome measures were postoperative interventions including reinstatement of IOP-lowering medications, bleb needling with 5-fluorouracil (5FU) or further glaucoma surgery, and the incidence of complications related to trabeculectomy and/or corneal graft surgery.
Results: There was no difference in pre-trabeculectomy IOP between DSAEK vs PK group (35.5 ± 10.1 vs 32.9 ± 8.9, P = .31). At 12 months after trabeculectomy, mean IOP in the DSAEK group was lower compared to the PK controls (10.6 ± 3.2 vs 14.6 ± 8.5, P = .04). The proportion of patients who achieved an IOP less than 12 mm Hg was significantly higher in the DSAEK group (80.0% vs 48.6%, P = .03). The proportions of eyes that required intervention after trabeculectomy were comparable between the 2 groups (DSAEK vs PK, all interventions: 20.0% vs 39.5%, P = .15; IOP-lowering medications required: 15.0% vs 39.5%, P = .08; needling with 5FU: 20.0% vs 23.7%, P > .99; further glaucoma surgery: 0% vs 13.2%, P = .15). Corneal graft failure arising after trabeculectomy was seen in 10.0% of DSAEK cases and in 10.5% of PK controls (P = 1.0).
Conclusion: Compared to trabeculectomy after PK, trabeculectomy after DSAEK achieved lower mean IOP at 12 months, and a larger proportion of DSAEK patients achieved an IOP of less than 12 mm Hg. There was no difference in the need for intervention after trabeculectomy, or incidence of other complications. Trabeculectomy is an effective surgical procedure for the management of postgraft ocular hypertension in DSAEK patients, and DSAEK may have an advantage in terms of success of trabeculectomy surgery over PK.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.ajo.2011.12.014 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Impact of Glaucoma Surgery on Corneal Graft Survival After Keratoplasty: A Systematic Review and Meta-Analysis.
J Glaucoma
January 2025
Department of Ophthalmology, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
Precis: Glaucoma surgery impacts corneal graft survival differently by procedure type, with GDDs being most effective at reducing intraocular pressure. However, graft survival rates are comparable across trabeculectomy, CPC, and GDDs. Trabeculectomy improves visual acuity best but often requires additional interventions.
View Article and Find Full Text PDFAhmed glaucoma valve implant for refractory glaucoma in children: A systematic review and meta-analysis.
Sci Prog
January 2025
School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
Purpose: The aim of this study was to evaluate the efficacy and safety of the Ahmed glaucoma valve in pediatric patients with refractory glaucoma.
Methods: A comprehensive literature search was conducted across multiple major databases, including PubMed, Embase, the Cochrane Library of Systematic Reviews, Science Direct, China's National Knowledge Infrastructure, and the Wanfang database. We retrieved studies published before December 2022 that met the inclusion criteria, including clinical controlled trials (randomized controlled trials) and clinical noncontrolled trials (non-randomized controlled trials) on the use of Ahmed glaucoma valve in pediatric patients with refractory glaucoma.
Complications After Incisional/Excisional Minimally Invasive Glaucoma Surgery-An Update and Literature Review.
Semin Ophthalmol
January 2025
Glaucoma Service, LV Prasad Eye Institute, Hyderabad, India.
Purpose: To discuss comprehensively the varied complications after stent-less incisional or excisional minimally invasive glaucoma surgery (MIGS).
Method: A review of reported complications after stent-less MIGS procedures including gonioscopy-assisted transluminal trabeculotomy (GATT), bent needle goniectomy (BANG), Kahook-dual blade goniotomy, and microincisional trabeculectomy (MIT) published between 2014-2024, were analyzed and summarized.
Results: Apart from hyphema, peripheral anterior synechiae, and intraocular pressure spikes, other vision-threatening complications like cyclodialysis, Descemet's detachment, corneal edema, iridodilalysis, vitreous loss or vitreous hemorrhage can also occur intra- or postoperatively after any incisional or excisional MIGS procedures.
Factors associated with the time of glaucoma-related adverse events onset after pediatric cataract surgery and the preferred anti-glaucomatous surgical selection.
Int Ophthalmol
January 2025
Department of Ophthalmology and Visual Science, Eye and ENT Hospital, Shanghai Medical College, Fudan University, 83 Fenyang Road, Shanghai, 200031, China.
Purpose: To describe the clinical characteristics of glaucoma-related adverse events (GRAE) after pediatric cataract surgery. More importantly, to identify the factors associated with the time of GRAE onset and the preferred anti-glaucomatous surgical procedure for this disease.
Methods: Hospitalized medical records of patients who developed GRAE, which include glaucoma and glaucoma suspect, after pediatric cataract surgery (surgical age ≤ 14 years) between 1994 and 2021 were retrospectively reviewed.
Assessing microcatheter-assisted 360-degree trabeculotomy combined with trabeculectomy for refractory glaucoma: 1-year results.
Int J Ophthalmol
January 2025
Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China.
Aim: To evaluate the efficacy and safety of microcatheter-assisted 360-degree trabeculotomy combined with trabeculectomy (MATT-Trab) for treating refractory glaucoma.
Methods: Patients with refractory glaucoma who underwent MATT-Trab were retrospectively examined. Efficacy indicators for research statistics included the intraocular pressure (IOP) level, degree of decrease, changes in medication dosage, and success rate.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!