Early results of descemet-stripping and automated endothelial keratoplasty (DSAEK) in patients with glaucoma drainage devices

Kamran M. Riaz, Joel Sugar, Elmer Y. Tu, Deepak P. Edward, Jacob T. Wilensky, Abed Namavari, Ali R. Djalilian

Research output: Contribution to journalArticle

Abstract

PURPOSE: To evaluate the outcome of Descemet-stripping and automated endothelial keratoplasty (DSAEK) in patients with glaucoma tube shunts in the anterior chamber. METHODS: Retrospective review of 4 patients with a history of tube shunt placement that experienced corneal decompensation and subsequently underwent DSAEK at 1 institution. Details of the surgical procedures as well as postoperative features including graft attachment, visual acuity, intraocular pressure (IOP), graft clarity, and central corneal thickness were recorded. RESULTS: There were no graft detachments postoperatively. In all but 1 case, the corneal edema resolved with a corresponding decrease in corneal thickness. In 1 case, where there was excessive donor tissue manipulation intraoperatively, the edema failed to resolve. This patient underwent a repeat DSAEK with subsequent graft attachment and resolution of the corneal edema. In all 4 patients, the tube shunt was revised at the time of DSAEK. The tube was not tied or plugged in any of the patients. Except for 1 patient with fibrin reaction, there were no IOP spikes postoperatively. At the 6-month follow-up, the visual acuity had improved in all patients and the IOP had not changed significantly from preoperative levels. CONCLUSION: This small series suggests that DSAEK is a viable and effective option in patients with existing tube shunts. The presence of a tube did not affect the rate of graft dislocation; however, it appeared to increased the rate of complications postoperatively. These early outcomes support the use of DSAEK as an alternative to penetrating keratoplasty in this patient population.

Original languageEnglish (US)
Pages (from-to)959-962
Number of pages4
JournalCornea
Volume28
Issue number9
DOIs
StatePublished - Oct 2009
Externally publishedYes

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Descemet Stripping Endothelial Keratoplasty
Glaucoma
Drainage
Equipment and Supplies
Transplants
Intraocular Pressure
Corneal Edema
Visual Acuity
Penetrating Keratoplasty
Anterior Chamber
Fibrin
Edema
Tissue Donors

Keywords

  • Air bubble
  • DSAEK
  • Tube shunt

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Riaz, K. M., Sugar, J., Tu, E. Y., Edward, D. P., Wilensky, J. T., Namavari, A., & Djalilian, A. R. (2009). Early results of descemet-stripping and automated endothelial keratoplasty (DSAEK) in patients with glaucoma drainage devices. Cornea, 28(9), 959-962. https://doi.org/10.1097/ICO.0b013e31819c4e2c

Early results of descemet-stripping and automated endothelial keratoplasty (DSAEK) in patients with glaucoma drainage devices. / Riaz, Kamran M.; Sugar, Joel; Tu, Elmer Y.; Edward, Deepak P.; Wilensky, Jacob T.; Namavari, Abed; Djalilian, Ali R.

In: Cornea, Vol. 28, No. 9, 10.2009, p. 959-962.

Research output: Contribution to journalArticle

Riaz, KM, Sugar, J, Tu, EY, Edward, DP, Wilensky, JT, Namavari, A & Djalilian, AR 2009, 'Early results of descemet-stripping and automated endothelial keratoplasty (DSAEK) in patients with glaucoma drainage devices', Cornea, vol. 28, no. 9, pp. 959-962. https://doi.org/10.1097/ICO.0b013e31819c4e2c
Riaz, Kamran M. ; Sugar, Joel ; Tu, Elmer Y. ; Edward, Deepak P. ; Wilensky, Jacob T. ; Namavari, Abed ; Djalilian, Ali R. / Early results of descemet-stripping and automated endothelial keratoplasty (DSAEK) in patients with glaucoma drainage devices. In: Cornea. 2009 ; Vol. 28, No. 9. pp. 959-962.
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AU - Wilensky, Jacob T.

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AU - Djalilian, Ali R.

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N2 - PURPOSE: To evaluate the outcome of Descemet-stripping and automated endothelial keratoplasty (DSAEK) in patients with glaucoma tube shunts in the anterior chamber. METHODS: Retrospective review of 4 patients with a history of tube shunt placement that experienced corneal decompensation and subsequently underwent DSAEK at 1 institution. Details of the surgical procedures as well as postoperative features including graft attachment, visual acuity, intraocular pressure (IOP), graft clarity, and central corneal thickness were recorded. RESULTS: There were no graft detachments postoperatively. In all but 1 case, the corneal edema resolved with a corresponding decrease in corneal thickness. In 1 case, where there was excessive donor tissue manipulation intraoperatively, the edema failed to resolve. This patient underwent a repeat DSAEK with subsequent graft attachment and resolution of the corneal edema. In all 4 patients, the tube shunt was revised at the time of DSAEK. The tube was not tied or plugged in any of the patients. Except for 1 patient with fibrin reaction, there were no IOP spikes postoperatively. At the 6-month follow-up, the visual acuity had improved in all patients and the IOP had not changed significantly from preoperative levels. CONCLUSION: This small series suggests that DSAEK is a viable and effective option in patients with existing tube shunts. The presence of a tube did not affect the rate of graft dislocation; however, it appeared to increased the rate of complications postoperatively. These early outcomes support the use of DSAEK as an alternative to penetrating keratoplasty in this patient population.

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