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Glaucoma drainage device implantation and cyclophotocoagulation in the management of refractory glaucoma after Descemet-stripping automated endothelial keratoplasty

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International Journal of Ophthalmology(English edition) 2024年第2期17卷 257-264页

作者： Min-Shu Wang Xue-Chuan Dong Mi-Yun Zheng Xiang Fan Ge-Ge Xiao Jing Hong Ling-Ling Wu Department of Ophthalmology Peking University Third HospitalBeijing 100191China Key Laboratory of Restoration of Damaged Ocular Nerve Beijing 100191China NIMO Ophthalmology Research Institute Beijing 100176China Department of Ophthalmology the First Hospital of PutianTeaching HospitalFujian Medical UniversityPutian 351100Fujian ProvinceChina

AIM:To compare the surgical outcomes of glaucoma drainage device implantation(GDI)and trans-scleral neodymium:YAG cyclophotocoagulation(CPC)in the management of refractory glaucoma after descemetstripping automated endothelial keratoplasty(DSAEK).METHODS:This retrospective study on observational case series enrolled 29 patients who underwent DSAEK and posterior anti-glaucoma surgery(15 with GDI and 14 with CPC).The main outcome measures were intraocular pressure(IOP),glaucoma surgery success rate(defined as IOP of 6–21 mm Hg without additional anti-glaucoma operation),number of glaucoma medications,endothelial graft status,and best-corrected visual acuity(BCVA).RESULTS:The mean follow-up time was 34.1 and 21.0mo for DSAEK or glaucoma surgeries,both for the GDI and CPC *** groups showed significant IOP reduction after glaucoma *** GDI group presented a significantly higher success rate in IOP control than the CPC group(60%vs 21.4%,P=0.03).Both procedures significantly decreased the number of glaucoma medications(P=0.03).Forty percent and 57%of cases in the GDI and the CPC group,respectively,experienced endothelial graft failure during follow-up(P=0.36).Significantly worse BCVA after surgery was observed in the CPC group but not in the GDI ***:Both GDI and CPC significantly decrease IOP in eyes with glaucoma after *** is preferable to CPC in refractory glaucoma cases after DSAEK,as it manifests a significantly higher success rate for IOP control,similar endothelial graft failure rate,and relatively preserves BCVA than CPC.

关键词： glaucoma drainage device implantation cyclophotocoagulation refractory glaucoma descemetstripping automated endothelial keratoplasty

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