Glaucoma therapy escalation in eyes with pseudophakic corneal edema after penetrating keratoplasty and Descemet's stripping automated endothelial keratoplasty

George R Wandling Jr; Matthew P Rauen; Kenneth M Goins; Anna S Kitzmann; John E Sutphin; Young H Kwon; Wallace L M Alward; Michael D Wagoner

doi:10.1007/s10792-011-9512-2

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Glaucoma therapy escalation in eyes with pseudophakic corneal edema after penetrating keratoplasty and Descemet's stripping automated endothelial keratoplasty

Journal article

Peer reviewed

Glaucoma therapy escalation in eyes with pseudophakic corneal edema after penetrating keratoplasty and Descemet's stripping automated endothelial keratoplasty

George R Wandling Jr, Matthew P Rauen, Kenneth M Goins, Anna S Kitzmann, John E Sutphin, Young H Kwon, Wallace L M Alward and Michael D Wagoner

International ophthalmology, Vol.32(1), pp.9-14

02/2012

DOI: 10.1007/s10792-011-9512-2

PMID: 22246622

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Abstract

The purpose of this study was to determine and compare the prevalence of glaucoma therapy escalation (GTE) after penetrating keratoplasty (PKP) and Descemet's stripping automated endothelial keratoplasty (DSAEK) in eyes with a surgical indication of pseudophakic corneal edema. A retrospective review was conducted of the medical records of all patients who underwent PKP or DSAEK to treat pseudophakic corneal edema at a tertiary eye care center from January 1 2003 to December 31, 2006. Eyes that were treated with PKP from January 1, 2003 to December 31, 2004 and with DSAEK from January 1, 2005 to December 31, 2006 were included in the statistical analysis. Inclusion criteria included satisfactory preoperative control of intraocular pressure (IOP) and follow-up of at least 12 months. The main outcome measure was GTE, which was defined as a sustained requirement for escalation of topical medical therapy or the need to provide surgical intervention to maintain a satisfactory postoperative IOP. Among 54 eyes that met the inclusion criteria, GTE occurred in 7 (35.0%) of 20 eyes after PKP and in 14 (41.2%) of 34 eyes after DSAEK (P = 0.78) during a mean follow-up period of 27.6 and 28.6 months, respectively. Surgical escalation occurred in 2 (10.0%) eyes after PKP and 2 (5.9%) eyes after DSAEK (P = 0.62), and was associated with late-onset endothelial graft failure in all four eyes. Glaucoma therapy escalation is relatively common and occurs with comparable frequency in eyes with pseudophakic corneal edema after PKP and DSAEK.

Glaucoma - etiology

Follow-Up Studies

Humans

Middle Aged

Antihypertensive Agents - administration & dosage

Male

Keratoplasty, Penetrating - methods

Corneal Edema - surgery

Time Factors

Pseudophakia - diagnosis

Aged, 80 and over

Ophthalmic Solutions

Female

Retrospective Studies

Corneal Edema - diagnosis

Postoperative Complications

Glaucoma - physiopathology

Keratoplasty, Penetrating - adverse effects

Intraocular Pressure

Treatment Outcome

Visual Acuity

Descemet Stripping Endothelial Keratoplasty - methods

Disease Progression

Descemet Stripping Endothelial Keratoplasty - adverse effects

Pseudophakia - surgery

Glaucoma - therapy

Aged

Details

Title: Subtitle: Glaucoma therapy escalation in eyes with pseudophakic corneal edema after penetrating keratoplasty and Descemet's stripping automated endothelial keratoplasty
Creators: George R Wandling Jr - University of Iowa
Matthew P Rauen
Kenneth M Goins
Anna S Kitzmann
John E Sutphin
Young H Kwon
Wallace L M Alward
Michael D Wagoner
Resource Type: Journal article
Publication Details: International ophthalmology, Vol.32(1), pp.9-14
Publisher: Netherlands
DOI: 10.1007/s10792-011-9512-2
PMID: 22246622
ISSN: 0165-5701
eISSN: 1573-2630
Language: English
Date published: 02/2012
Academic Unit: Ophthalmology and Visual Sciences
Record Identifier: 9983980088002771

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