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

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Abstract

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/mm2 (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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Data availability

All data generated or analyzed during this study are included in this published article.

Abbreviations

AC:

Anterior chamber

AGV:

Ahmed valve implantation

BCVA:

Best corrected visual acuity

CCT:

Central corneal thickness

DMEK:

Descemet Membrane Endothelial Keratoplasty

DSAEK:

Descemet Stripping Automated Endothelial Keratoplasty

ECD:

Endothelial cell density

GAT:

Goldmann applanation tonometry

IOP:

Intraocular pressure

MIGS:

Micro-invasive glaucoma surgery

TS-CPC:

Transscleral cyclophotocoagulation

PXG:

Pseudoexfoliative glaucoma

POAG:

Primary open-angle glaucoma

pKPL:

Penetrating keratoplasty

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Acknowledgements

The authors received no outside financial support for this study, including pharmaceutical or industry support.

Funding

No funding was received for conducting this study.

Author information

Authors and Affiliations

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

    Sofia Fili, Kalliopi Kontopoulou & Markus Kohlhaas

  2. Department of Ophthalmology, University Hospital of Essen, Essen, Germany

    Nikolaos Bechrakis

Authors
  1. Sofia Fili
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  2. Kalliopi Kontopoulou
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  3. Nikolaos Bechrakis
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  4. Markus Kohlhaas
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by SF, KK, NB and MK. The first draft of the manuscript was written by SF and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Sofia Fili.

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Conflict of interest

The authors declare that there is no conflict of interest. All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers' bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

Ethical approval

All procedures performed in this observational retrospective study involving human participants were in accordance with the ethical standards of the institutional research committee of St-Johannes-Hospital in Dortmund, Germany, and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Clinical trial registration

This is an observational non-randomized retrospective study, and no clinical trial registration is necessary.

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Informed consent for participation is not mandatory in a retrospective study.

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Informed consent for publication was obtained from all individual participants included in the study.

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No research is performed on animals in this study.

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Fili, S., Kontopoulou, K., Bechrakis, N. et al. Corneal transplant survival rate in glaucoma patients with multiple previous antiglaucoma surgeries. Int Ophthalmol 41, 3387–3399 (2021). https://doi.org/10.1007/s10792-021-01902-1

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  • DOI: https://doi.org/10.1007/s10792-021-01902-1

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