Penetrating keratoplasty with pars plana glaucoma drainage devices.
OBJECTIVE
To study the outcome of penetrating keratoplasty (PK) in eyes undergoing simultaneous insertion or repositioning of a glaucoma drainage device (GDD) through the pars plana.


METHODS
The medical records of all patients who underwent PK and primary placement or repositioning of a GDD through the pars plana from April 1, 1997, through December 1, 2005, were reviewed. Intraocular pressure (IOP) control was defined as maintenance of IOP > or = 5 and < or = 21 mm Hg (without loss of light perception vision or needing further glaucoma surgery). Kaplan-Meier life table survival analysis was used to estimate the success of graft survival (clarity) and glaucoma control.


RESULTS
Eighty-three eyes of 80 patients (34 men and 46 women) were identified. Mean follow-up was 16 months (range, 6-96 months). PK and pars plana vitrectomy were performed with primary pars plana GDD insertion (57 eyes) or tube repositioning from the anterior chamber to pars plana (26 eyes). Grafts remained clear in 93% of eyes (76/83) at 6 months, 87% (56/66) at 1 year, and 59% (19/32) at 2 years. IOP was controlled in 87% (72/83) of eyes at 6 months, 95% (57/63) at 1 year, and 83% (20/24) at 2 years.


CONCLUSIONS
PK with simultaneous pars plana GDD repositioning or placement showed comparable short- and long-term IOP control to that of previous studies with limbal-based GDD. The rate of corneal graft failure and the rate of immunologic rejection were comparable to or lower than those reported in other series with primary limbal-based GDD.
Ritterband
David C
DC
Department of Ophthalmology, New York Eye & Ear Infirmary, New York, NY 10003, USA. ritterband@msn.com
Shapiro
Daniel
D
Trubnik
Valeriya
V
Marmor
Michael
M
Meskin
Seth
S
Seedor
John
J
Liebmann
Jeffrey M
JM
Tello
Celso
C
Koplin
Richard
R
Harizman
Noga
N
Shabto
Uri
U
Ritch
Robert
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002386:Cataract / Q000150:complications*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005901:Glaucoma / Q000150:complications*; D020327:Glaucoma Drainage Implants; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D015948:Keratoplasty, Penetrating / Q000379:methods*; D019654:Lens Implantation, Intraocular; D008297:Male; D008875:Middle Aged; D019919:Prosthesis Implantation; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy