1 / 12

Descemet s Stripping Endothelial Keratoplasty after Glaucoma Surgery

DSEK after Glaucoma Surgery. Safe?Effective?. Potential Problems with DSEK after Glaucoma Surgery. Donor adherence - air leaving the ACTrabeculectomy/tube failure - IOPGraft failure. . . DSEK Postops. Tube patient with previous failed PK; clear after DSEK. Bubble partially escapes day 1 through functioning trab.

omer
Download Presentation

Descemet s Stripping Endothelial Keratoplasty after Glaucoma Surgery

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

    1. Descemet’s Stripping Endothelial Keratoplasty after Glaucoma Surgery Adam Easterling, M.D. Alan Carlson, M.D. Duke University Eye Center ASCRS Meeting 2007

    2. DSEK after Glaucoma Surgery Safe? Effective?

    3. Potential Problems with DSEK after Glaucoma Surgery Donor adherence - air leaving the AC Trabeculectomy/tube failure - IOP Graft failure

    4. DSEK Postops Tube patient with previous failed PK; clear after DSEK Bubble partially escapes day 1 through functioning trab

    5. Our Study Retrospective chart review of first 51 patients to have DSEK at DUEC with at least one month of follow-up Two groups: 1) 39 patients with no previous history of invasive glaucoma surgery 2) 12 patients with a trabeculectomy or glaucoma drainage device (2 trabs, 10 tubes)

    6. Surgery All patients had similar surgery with a sutured limbal wound Approximately 50% air fill in anterior chamber at the end of the case to promote donor adherence Controls lie supine for 60 minutes Group 2 lie supine for 60-90 minutes

    7. Outcome Measures Preoperative and postoperative IOP Number of glaucoma medications used preoperatively and postoperatively Graft dislocation

    8. Intraocular Pressure Control

    9. Glaucoma Medications

    10. Graft dislocation Defined as need for injection of air into the AC and/or a repeat graft for poor donor adherence

    11. Discussion With regards to IOP control and donor adherence, DSEK appears to be a safe procedure after glaucoma surgery with no significant increase in the number of glaucoma drops needed 60-90 minute supine positioning is effective at promoting donor adherence Graft dislocation is likely related to surgeon experience1, not to previous glaucoma surgery 1. Price, et al. JCRS 2006 March; 32:411-418

    12. Tube/Trab patient with corneal decompensation? Consider DSEK Thanks to: Terry Kim, M.D. Natalie Afshari, M.D. Felix Chau, M.D. Sandra Stinnett, DrPH

More Related