Skip to main content

Advertisement

SpringerLink
Log in

Comparison of graft survival following penetrating keratoplasty and Descemet’s stripping endothelial keratoplasty in eyes with a glaucoma drainage device

  • Original Paper
  • Published:
International Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

To compare corneal graft survival rates after penetrating keratoplasty (PK) and Descemet’s stripping endothelial keratoplasty (DSEK) in patients with a glaucoma drainage device (GDD) or medically managed glaucoma.

Methods

A retrospective chart review was conducted on consecutive patients who underwent primary PK or primary DSEK. Inclusion criteria consisted of eyes with a diagnosis of glaucoma prior to corneal transplantation and a minimum of 6 months of follow-up. Graft failure was defined as an edematous cornea with failure to maintain deturgescence lasting beyond a period of 1 month of intense steroid therapy or vascularization and scarring resulting in irreversible loss of central graft clarity. Corneal graft survival was calculated using Kaplan–Meier survival analysis. Patients were divided into four groups: GDD-PK, GDD-DSEK, medical-PK and medical-DSEK.

Results

Fifty-six eyes of 56 patients were identified as meeting inclusion criteria. Among eyes with a GDD, there was no difference in the proportion of failures between PK grafts (48%) and DSEK grafts (50%) (p = 0.90). Failure occurred earlier in DSEK recipients compared to PK recipients, 5.82 ± 6.77 months versus 14.40 ± 7.70 months, respectively (p = 0.04). A Kaplan–Meier analysis did not identify a difference between the four groups with respect to graft failure (p = 0.52).

Conclusion

There is no significant difference in graft survival rates between medically and surgically treated glaucoma patients for either PK or DSEK grafts. In patients with GDD, graft failure occurs earlier in DSEK compared to PK.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Tan DT, Dart JK, Holland JE, Kinoshita S (2012) Corneal transplantation. Lancet 379:1749–1761

    Article  PubMed  Google Scholar 

  2. Price FW Jr, Price MO (2005) Descemet’s stripping with endothelial keratoplasty in 50 eyes: a refractive neutral corneal transplant. J Refract Surg 21:339–345

    PubMed  Google Scholar 

  3. Anshu A, Price MO, Tan DTH, Price FW Jr (2012) Endothelial keratoplasty: a revolution in evolution. Surv Ophthalmol 57:236–252

    Article  PubMed  Google Scholar 

  4. Nanavaty MA, Wang X, Shortt AJ (2014) Endothelial keratoplasty versus penetrating keratoplasty for Fuchs endothelial dystrophy. Cochrane Database Syst Rev 2:CD008420. doi:10.1002/14651858.CD008420.pub3

    PubMed Central  Google Scholar 

  5. Kosker M, Suri K, Duman F, Hammersmith KM, Nagra PK, Rapuano CJ (2013) Long-term outcomes of penetrating keratoplasty and Descemet stripping endothelial keratoplasty for Fuchs endothelial dystrophy: fellow eye comparison. Cornea 32:1083–1088

    Article  PubMed  Google Scholar 

  6. Price MO, Gorovoy M, Price FW Jr, Benetz BA, Menegay HJ, Lass JH (2013) Descemet’s stripping automated endothelial keratoplasty: three-year graft and endothelial cell survival compared with penetrating keratoplasty. Ophthalmology 120:246–251

    Article  PubMed  Google Scholar 

  7. Duman F, Kosker M, Suri K, Reddy JC, Ma JF, Hammersmith KM, Nagra PK, Rapuano CJ (2013) Indications and outcomes of corneal transplantation in geriatric patients. Am J Ophthalmol 156:600–607

    Article  PubMed  Google Scholar 

  8. Anshu A, Price MO, Price FW (2012) Descemet’s stripping endothelial keratoplasty: long-term graft survival and risk factors for failure in eyes with preexisting glaucoma. Ophthalmology 119:1982–1987

    Article  PubMed  Google Scholar 

  9. Price MO, Fairchild KM, Price DA, Price FW Jr (2011) Descemet’s stripping endothelial keratoplasty five-year graft survival and endothelial cell loss. Ophthalmology 118:725–729

    Article  PubMed  Google Scholar 

  10. Price MO, Gorovoy M, Benetz BA, Price FW Jr, Menegay HJ, Debanne SM, Lass JH (2010) Descemet’s stripping automated endothelial keratoplasty outcomes compared with penetrating keratoplasty from the cornea donor study. Ophthalmology 117:438–444

    Article  PubMed  PubMed Central  Google Scholar 

  11. Lee WB, Jacobs DS, Musch DC, Kaufman SC, Reinhart WJ, Shtein RM (2009) Descemet’s stripping endothelial keratoplasty: safety and outcomes: a report by the American Academy of Ophthalmology. Ophthalmology 116:1818–1830

    Article  PubMed  Google Scholar 

  12. Allan BD, Terry MA, Price FW Jr, Price MO, Griffin NB, Claesson M (2007) Corneal transplant rejection rate and severity after endothelial keratoplasty. Cornea 26:1039–1042

    Article  PubMed  Google Scholar 

  13. Beckingsale P, Mavrikakis I, Al-Yousuf N, Mavrikakis E, Daya SM (2006) Penetrating keratoplasty: outcomes from a corneal unit compared to national data. Br J Ophthalmol 90:726–731

    Article  Google Scholar 

  14. Stewart RMK, Jones MNA, Batterbury M, Tole D, Larkin DF, Kaye SB (2011) NHSBT ocular tissue advisory group and contributing ophthalmologists (OTAG Audit Study 9). Effect of glaucoma on corneal graft survival according to indication for penetrating keratoplasty. Am J Ophthalmol 151:257–262

    Article  PubMed  Google Scholar 

  15. Reinhard T, Kallmann C, Cepin A, Godehardt E, Sundmacher R (1997) The influence of glaucoma history on graft survival after penetrating keratoplasty. Graefes Arch Clin Exp Ophthalmol 235:553–557

    Article  CAS  PubMed  Google Scholar 

  16. Maguire MG, Stark WJ, Gottsch JD, Stulting RD, Sugar A, Fink NE, Schwartz A (1994) Collaborative corneal transplantation studies research group. Risk factors for corneal graft failure and rejection in the collaborative corneal transplantation studies. Ophthalmology 101:1536–1547

    Article  CAS  PubMed  Google Scholar 

  17. Wiaux C, Baghdasaryan E, Lee OL, Bourges JL, Deng SX, Yu F, Aldave AJ (2011) Outcomes after Descemet stripping endothelial keratoplasty in glaucoma pateints with previous trabeculectomy and tube shunt implantation. Cornea 30:1304–1311

    Article  PubMed  Google Scholar 

  18. Lieberman RA, Maris PJ Jr, Monroe HM, Al-Aswad LA, Bansal R, Lopez R, Florakis GJ (2012) Corneal graft survival and intraocular pressure control in coexisting penetrating keratoplasty and pars plana Ahmed Glaucoma Valves. Cornea 31:350–358

    Article  PubMed  Google Scholar 

  19. Knape RM, Szymarek TN, Tuli SS, Driebe WT, Sherwood MB, Smith MF (2012) Five-year outcomes of eyes with glaucoma drainage device and penetrating keratoplasty. J Glaucoma 21:608–614

    Article  PubMed  PubMed Central  Google Scholar 

  20. Kwon YH, Taylor JM, Hong S, Honkanen RA, Zimmerman MB, Alward WL, Sutphin JE (2001) Long-term results of eyes with penetrating keratoplasty and glaucoma drainage tube implant. Ophthalmology 108:272–278

    Article  CAS  PubMed  Google Scholar 

  21. Topouzis F, Coleman AL, Choplin N, Bethlem MM, Hill R, Yu F, Panek WC, Wilson MR (1999) Follow-up of the original cohort with the Ahmed glaucoma valve implant. Am J Ophthalmol 128:198–204

    Article  CAS  PubMed  Google Scholar 

  22. Witmer MT, Tiedeman JS, Oisakovsky LA, Conaway MR, Prum BE (2010) Long-term intraocular pressure control and corneal graft survival in eyes with a pars plana Baerveldt implant and corneal transplant. J Glaucoma 19:124–131

    Article  PubMed  Google Scholar 

  23. Thompson RW Jr, Price MO, Bowers PJ, Price FW Jr (2003) Long-term graft survival after penetrating keratoplasty. Ophthalmology 110:1396–1402

    Article  PubMed  Google Scholar 

  24. Ing JJ, Ing HH, Nelson LR, Hodge DO, Bourne WM (1998) Ten-year postoperative results of penetrating keratoplasty. Ophthalmology 105:1855–1865

    Article  CAS  PubMed  Google Scholar 

  25. Price FW Jr, Whitson WE, Collins KS, Marks RG (1993) Five-year corneal graft survival. A large, single-center patient cohort. Arch Ophthalmol 111:799–805

    Article  PubMed  Google Scholar 

  26. Ramulu PY, Corcoran KJ, Corcoran SL, Robin AL (2007) Utilization of various glaucoma surgeries and procedures in Medicare beneficiaries from 1995-2004. Ophthalmology 114:2265–2270

    Article  PubMed  Google Scholar 

  27. Rosenberg LF, Krupin T (1996) Implants in glaucoma surgery. In: Ritch R, Shields MB, Krupin T (eds) The glaucomas, 2nd edn. Mosby, Philadelphia, pp 1783–1807

    Google Scholar 

  28. Sugar A, Tanner JP, Dontchev M, Tennant B, Schultze RL, Dunn SP, Lindquist TD, Gal RL, Beck RW, Kollman C, Mannis MJ (2009) Holland EJ; Cornea Donor Study Investigator Group. Recipient risk factors for graft failure in the cornea donor study. Ophthalmology 116:1023–1028

    Article  PubMed  PubMed Central  Google Scholar 

  29. Kim P, Amiran MD, Lichtinger A, Yeung SN, Slomovic AR, Rootman DS (2012) Outcomes of Descemet stripping automated endothelial keratoplasty in patients with previous glaucoma drainage device insertion. Cornea 31:172–175

    Article  PubMed  Google Scholar 

  30. Aldave AJ, Chen JL, Zaman AS, Deng SX, Yu F (2014) Outcomes after DSEK in 101 eyes with previous trabeculectomy and tube shunt implantation. Cornea 33:223–229

    Article  PubMed  Google Scholar 

  31. Forstot SL, Binder PS, Fitzgerald C, Kaufman HE (1975) The incidence of retinal detachment after penetrating keratoplasty. Am J Ophthalmol 80:102–105

    Article  CAS  PubMed  Google Scholar 

  32. Baudouin C (1996) Side effects of antiglaucomatous drugs on the ocular surface. Curr Opin Ophthalmol 7:80–86

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

NIH Grants—University of Miami Core Center Grant (P30-EY014801); an unrestricted grant from Research to Prevent Blindness, New York, New York; Department of Defense Grant (W81XWH-09-1-0675).

Author information

Authors and Affiliations

  1. Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 7101 Fairway Drive, Palm Beach Gardens, FL, 33418, USA

    Shawn M. Iverson, Oriel Spierer, George C. Papachristou, William J. Feuer, Wei Shi, David S. Greenfield & Terrence P. O’Brien

  2. Ophthalmology Division, Tel Aviv Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

    Oriel Spierer

Authors
  1. Shawn M. Iverson
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Oriel Spierer
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. George C. Papachristou
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. William J. Feuer
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Wei Shi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. David S. Greenfield
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Terrence P. O’Brien
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Terrence P. O’Brien.

Ethics declarations

Conflict of interest

The authors declare there are no conflicts of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Iverson, S.M., Spierer, O., Papachristou, G.C. et al. Comparison of graft survival following penetrating keratoplasty and Descemet’s stripping endothelial keratoplasty in eyes with a glaucoma drainage device. Int Ophthalmol 38, 223–231 (2018). https://doi.org/10.1007/s10792-017-0451-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10792-017-0451-4

Keywords

Search

Navigation