Penetrating keratoplasty with pars plana glaucoma drainage devices

David C. Ritterband, Daniel Shapiro, Valeriya Trubnik, Michael Marmor, Seth Meskin, John Seedor, Jeffrey M. Liebmann, Celso Tello, Richard Koplin, Noga Harizman, Uri Shabto, Robert Ritch, Andrew Prince, Daniel Laroche, David Pinhas, Lisa Gamel, Abha Amin, Paul Sidoti, Regina Smolyak, Peter WeseleyAlan Dayan, Thomas Muldoon, Kenneth Felder, Ronald Gentile, Gary Glickman, Richard Rosen

Research output: Contribution to journalArticlepeer-review

60 Scopus citations

Abstract

PURPOSE: To study the outcome of penetrating keratoplasty (PK) in eyes undergoing simultaneous insertion or repositioning of a glaucoma drainage device (GDD) through the pars plana. METHODS: The medical records of all patients who underwent PK and primary placement or repositioning of a GDD through the pars plana from April 1, 1997, through December 1, 2005, were reviewed. Intraocular pressure (IOP) control was defined as maintenance of IOP ≥5 and ≤21 mm Hg (without loss of light perception vision or needing further glaucoma surgery). Kaplan-Meier life table survival analysis was used to estimate the success of graft survival (clarity) and glaucoma control. RESULTS: Eighty-three eyes of 80 patients (34 men and 46 women) were identified. Mean follow-up was 16 months (range, 6-96 months). PK and pars plana vitrectomy were performed with primary pars plana GDD insertion (57 eyes) or tube repositioning from the anterior chamber to pars plana (26 eyes). Grafts remained clear in 93% of eyes (76/83) at 6 months, 87% (56/66) at 1 year, and 59% (19/32) at 2 years. IOP was controlled in 87% (72/83) of eyes at 6 months, 95% (57/63) at 1 year, and 83% (20/24) at 2 years. CONCLUSIONS: PK with simultaneous pars plana GDD repositioning or placement showed comparable short- and long-term IOP control to that of previous studies with limbal-based GDD. The rate of corneal graft failure and the rate of immunologic rejection were comparable to or lower than those reported in other series with primary limbal-based GDD.

Original languageEnglish
Pages (from-to)1060-1066
Number of pages7
JournalCornea
Volume26
Issue number9
DOIs
StatePublished - Oct 2007

Keywords

  • Glaucoma drainage devices
  • Pars plana glaucoma drainage devices
  • Penetrating keratoplasty

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