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Ophthalmology. 2012 Jun;119(6):1130-3. doi: 10.1016/j.ophtha.2012.01.012. Epub 2012 Mar 3.

Graft dislocation and hypotony after Descemet's stripping automated endothelial keratoplasty in patients with previous glaucoma surgery.

Author information

1
Devers Eye Institute, Portland, Oregon 97210, USA. jeffgoshe@gmail.com

Abstract

PURPOSE:

To determine if patients with prior glaucoma surgery experience higher rates of postoperative graft dislocation after Descemet's stripping automated endothelial keratoplasty (DSAEK) and to determine if postoperative hypotony may be a risk factor in these patients.

DESIGN:

Retrospective, comparative analysis of an interventional case series.

PARTICIPANTS:

Eight hundred fifty-four eyes (67 eyes with prior glaucoma surgery and 787 controls) from 582 patients who underwent DSAEK at 1 institution between January 2005 and April 2011.

METHODS:

Groups were compared with regard to preoperative, intraoperative, and postoperative parameters. Continuous variables were compared using the independent samples t test or Mann-Whitney U test. Categorical variables were compared using the chi-square test or Fisher exact test.

MAIN OUTCOME MEASURES:

Frequencies of postoperative graft dislocation and postoperative hypotony.

RESULTS:

Study eyes before surgery differed from control eyes with regard to corneal thickness (768 vs. 655 μm; P<0.001) and intraocular pressure (13 vs. 16 mmHg; P<0.001). Postoperative graft dislocation occurred significantly more frequently in study eyes compared with control eyes (9% vs. 2%; P = 0.008). Among eyes in which dislocation occurred, postoperative hypotony was present in 5 study eyes (83%) and 0 control eyes.

CONCLUSIONS:

Previous glaucoma surgery was associated with a significantly increased rate of graft dislocation compared with control eyes. Dislocation was related strongly to postoperative hypotony in eyes with prior glaucoma surgery.

FINANCIAL DISCLOSURE(S):

Proprietary or commercial disclosure may be found after the references.

PMID:
22385970
DOI:
10.1016/j.ophtha.2012.01.012
[Indexed for MEDLINE]

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