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Outcome of Descemet stripping automated endothelial keratoplasty in eyes with an Ahmed glaucoma valve

  • Cornea
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Abstract

Purpose

The purpose was to investigate the survival of Descemet stripping automated endothelial keratoplasty (DSAEK) in eyes with an Ahmed glaucoma valve (AGV).

Methods

The study had a retrospective case-series of patients with an AGV in the anterior chamber undergoing a DSAEK. Included in the analysis were graft size, number of previous operations, post-operative glaucoma medications, post-operative intraocular pressure (IOP) control, graft size and donor factors (age, endothelial cell density, and post-mortem time). A generalised linear model with binary logistic regression was used to test for an effect on graft survival at 1 year and 1.5 years.

Results

Fourteen eyes from 13 patients were included. The survival rate of the first DSAEK at 6, 12, 18, 24 and 30-months was 85%, 71%, 50%, 36% and 30%, respectively. The mean duration to graft failure was 12.9 ± 6.2 months. Five of the seven failed first grafts went on to have a repeat DSAEK. The mean follow-up in this subgroup was 30.7 ± 18.4 months. The survival rate of second DSAEK at 6, 12, 18 and 24 months was 100% (5/5), 100% (5/5), 75% (3/4) and 67% (2/3). Only one second DSAEK failed in the duration of the study and went on to receive a third DSAEK which failed at 18-months. The mean IOP within the first year was significantly lower for grafts that survived at 1 and 1.5 years (17.4 mmHg, 16.9 mmHg) than for grafts that failed (19.4 mmHg, 19.4 mmHg) (p = 0.04, p = 0.009).

Conclusion

DSAEK is a viable alternative to PK to restore visual function in eyes with an AGV sited in the anterior chamber. IOP is an important risk factor for graft failure.

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Authors and Affiliations

  1. St. Paul’s Eye Unit, Royal Liverpool University Hospital, Liverpool, England

    Patrick J Chiam, Robert Cheeseman, Vivian W Ho, Vito Romano, Anshoo Choudhary, Mark Batterbury, Stephen B Kaye & Colin E Willoughby

  2. Eye Care Centre, Leighton Hospital, Middlewich Road, Crewe, CW1 4QJ, England

    Patrick J Chiam

  3. Department of Eye and Vision Science, Institute of Ageing and Chronic Disease, Faculty of Health & Life Sciences, University of Liverpool, Liverpool, England

    Stephen B Kaye & Colin E Willoughby

Authors
  1. Patrick J Chiam
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  2. Robert Cheeseman
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  3. Vivian W Ho
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  4. Vito Romano
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  5. Anshoo Choudhary
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  6. Mark Batterbury
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  7. Stephen B Kaye
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  8. Colin E Willoughby
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Correspondence to Patrick J Chiam.

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No funding was received for this research.

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.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

For this type of study formal consent is not required.

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

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Chiam, P.J., Cheeseman, R., Ho, V.W. et al. Outcome of Descemet stripping automated endothelial keratoplasty in eyes with an Ahmed glaucoma valve. Graefes Arch Clin Exp Ophthalmol 255, 987–993 (2017). https://doi.org/10.1007/s00417-017-3612-2

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  • DOI: https://doi.org/10.1007/s00417-017-3612-2

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