Corneal transplant survival rate in glaucoma patients with multiple previous antiglaucoma surgeries.

Int Ophthalmol

Department of Ophthalmology, Clinic of Ophthalmology, St. Johannes Hospital, Johannesstraße 9-13, 44137, Dortmund, Germany.

Published: October 2021

Background: Glaucoma can cause corneal decompensation and accelerate the failure of the graft. Previous antiglaucoma operations are one of the most important risk factors for endothelial failure.

Methods: In this retrospective study, 40 eyes of 40 glaucoma patients with advanced corneal decompensation after glaucoma surgery were treated with keratoplasty and outcomes were assessed for 24 months.

Results: 16, 9 and 15 eyes underwent Descemet Membrane Endothelial Keratoplasty (DMEK), Descemet's Stripping Automated Endothelial Keratoplasty (DSAEK) and penetrating keratoplasty (pKPL), respectively. Visual acuity improved at least 2 lines in 24 of 40 eyes after the three types of keratoplasty. All 40 eyes remained pain free for the follow-up period. The mean intraocular pressure (IOP) difference was not significantly different (p > 0.05) from the preoperative values 12 and 24 months after keratoplasty. The endothelial cell density of the donor cornea decreased from 2485.6 ± 165.18 to 1291.4 ± 467.1 and 1180.4 ± 397.2/mm (p < 0.001) after 12 and 24 months, respectively. Nine eyes (22.5%) had therapy-resistant corneal decompensation in the context of a transplant failure and were treated with a re-keratoplasty (2 re-pKPLs, 3 re-DSAEKs and 3 re-DMEKs).

Conclusions: Eyes with previous glaucoma surgery show satisfying results after keratoplasty, mainly DMEK and pKPL.

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Source
http://dx.doi.org/10.1007/s10792-021-01902-1DOI Listing

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