Abstract | PURPOSE: DESIGN: Retrospective case-control study. METHODS: Patients within an institutional setting who underwent trabeculectomy with mitomycin C (MMC) for uncontrolled elevated intraocular pressure (IOP) after corneal graft surgery were included. Patients with pre-existing glaucoma were excluded. Twenty patients with trabeculectomy after DSAEK and 41 patients with trabeculectomy after PK were analyzed. The main outcome measure was IOP control at 12 months. Secondary outcome measures were postoperative interventions including reinstatement of IOP-lowering medications, bleb needling with 5-fluorouracil ( 5FU) or further glaucoma surgery, and the incidence of complications related to trabeculectomy and/or corneal graft surgery. RESULTS: There was no difference in pre- trabeculectomy IOP between DSAEK vs PK group (35.5 ± 10.1 vs 32.9 ± 8.9, P = .31). At 12 months after trabeculectomy, mean IOP in the DSAEK group was lower compared to the PK controls (10.6 ± 3.2 vs 14.6 ± 8.5, P = .04). The proportion of patients who achieved an IOP less than 12 mm Hg was significantly higher in the DSAEK group (80.0% vs 48.6%, P = .03). The proportions of eyes that required intervention after trabeculectomy were comparable between the 2 groups (DSAEK vs PK, all interventions: 20.0% vs 39.5%, P = .15; IOP-lowering medications required: 15.0% vs 39.5%, P = .08; needling with 5FU: 20.0% vs 23.7%, P > .99; further glaucoma surgery: 0% vs 13.2%, P = .15). Corneal graft failure arising after trabeculectomy was seen in 10.0% of DSAEK cases and in 10.5% of PK controls (P = 1.0). CONCLUSION:
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Authors | Pui Yi Boey, Jodhbir S Mehta, Ching Lin Ho, Donald T H Tan, Tina T Wong |
Journal | American journal of ophthalmology
(Am J Ophthalmol)
Vol. 153
Issue 6
Pg. 1091-8.e2
(Jun 2012)
ISSN: 1879-1891 [Electronic] United States |
PMID | 22397954
(Publication Type: Comparative Study, Journal Article)
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Copyright | Copyright © 2012 Elsevier Inc. All rights reserved. |
Chemical References |
- Alkylating Agents
- Mitomycin
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Topics |
- Alkylating Agents
(administration & dosage)
- Case-Control Studies
- Descemet Stripping Endothelial Keratoplasty
- Female
- Glaucoma
(etiology, physiopathology, surgery)
- Humans
- Intraocular Pressure
(physiology)
- Keratoplasty, Penetrating
- Male
- Middle Aged
- Mitomycin
(administration & dosage)
- Ocular Hypertension
(etiology, surgery)
- Postoperative Complications
- Retrospective Studies
- Tonometry, Ocular
- Trabeculectomy
- Treatment Outcome
- Visual Acuity
(physiology)
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