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

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

Research output: Contribution to journalArticle

5 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)1-9
Number of pages9
JournalInternational Ophthalmology
DOIs
StateAccepted/In press - Mar 16 2017

Fingerprint

Descemet Stripping Endothelial Keratoplasty
Penetrating Keratoplasty
Graft Survival
Glaucoma
Drainage
Equipment and Supplies
Transplants
Survival Rate
Equipment Failure
Corneal Transplantation
Survival Analysis
Cornea
Cicatrix
Steroids

Keywords

  • Corneal graft
  • Descemet’s stripping endothelial keratoplasty
  • Glaucoma drainage device
  • Glaucoma tube shunt
  • Graft failure
  • Penetrating keratoplasty

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Comparison of graft survival following penetrating keratoplasty and Descemet’s stripping endothelial keratoplasty in eyes with a glaucoma drainage device. / Iverson, Shawn M.; Spierer, Oriel; Papachristou, George C.; Feuer, William J; Shi, Wei; Greenfield, David; O'Brien, Terrence.

In: International Ophthalmology, 16.03.2017, p. 1-9.

Research output: Contribution to journalArticle

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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.",
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AU - Shi, Wei

AU - Greenfield, David

AU - O'Brien, Terrence

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N2 - 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.

AB - 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.

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