Association for Research in Vision and Ophthalmology

Association for Research in Vision and Ophthalmology

May 05, 2014
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Elevated IOP more common after DSAEK in patients with pre-existing glaucoma

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ORLANDO, Fla. — Patients with existing glaucoma who underwent Descemet’s stripping automated endothelial keratoplasty had higher postoperative IOP rates than patients without pre-existing glaucoma, a study found.

Pre-existing glaucoma was defined as IOP greater than 22 mm Hg that required medical or surgical treatment.

“Aggressive preoperative control of glaucoma may be required for DSAEK patients as is needed for PK patients,” Farihah Anwar, MD, and colleagues said in a poster at the Association for Research in Vision and Ophthalmology meeting.The retrospective study included 194 eyes that underwent DSAEK; 71 eyes had glaucoma preoperatively and 123 eyes did not. All procedures were performed by three surgeons in a 5-year period.

Thirty-one eyes with pre-existing glaucoma were prescribed eye drops to manage IOP after DSAEK compared with 23 eyes without pre-existing glaucoma (P < .0002).

In eyes with pre-existing glaucoma, 11 eyes needed a tube shunt after DSAEK, whereas only one eye without pre-existing glaucoma needed a tube shunt postoperatively.

A triple procedure — cataract extraction, IOL placement and corneal transplant — was necessary in 10.3% of all eyes and was significantly associated with the need for additional drops postoperatively (P < .0001).

No eyes with preoperative tube shunt or trabeculectomy required additional glaucoma surgery after DSAEK.

“Glaucoma can have postoperative complications due to DSAEK. Doctors should establish medical control prior to the DSAEK procedure to stage DSAEK to limit glaucoma complications,” Anwar said.

Disclosure: Anwar has no relevant financial disclosures.