Management of endothelial decompensation because of glaucoma shunt tube touch by Descemet membrane endothelial keratoplasty and tube revision.
OBJECTIVE
To describe the trimming of a glaucoma shunt tube with Descemet membrane endothelial keratoplasty (DMEK) for the treatment of endothelial decompensation caused by tube-endothelium touch.


METHODS
An 84-year-old man with pseudoexfoliative glaucoma OU had endothelial decompensation because of the touch of the tube of an Ahmed glaucoma valve at the corneal endothelium OS. The best-corrected visual acuity decreased from 20/60 to counting fingers at 3 feet. The patient underwent uncomplicated trimming of the shunt tube and DMEK.


RESULTS
After surgery, the cornea became clear, and the best-corrected visual acuity improved to 20/60. The intraocular pressure remained normal (8-12 mm Hg) without antiglaucoma medications, and endothelial cell count remained stable in a follow-up of 12 months. No complications were encountered.


CONCLUSIONS
Glaucoma shunt tube trimming with DMEK may be considered in cases of endothelial decompensation because of tube-endothelium touch and may replace penetrating keratoplasty and other posterior lamellar procedures for such cases.
Department of Ophthalmology, Western Galilee-Nahariya Medical Center, Nahariya, Israel.
Valery
V
Bersudsky
Aaron
A
Treviño
Shimon
S
Rumelt
D000369:Aged, 80 and over; D000867:Anterior Chamber / Q000473:pathology; D015715:Corneal Edema / Q000209:etiology / Q000601:surgery*; D057111:Descemet Stripping Endothelial Keratoplasty; D004728:Endothelium, Corneal / Q000473:pathology*; D017889:Exfoliation Syndrome / Q000601:surgery; D020327:Glaucoma Drainage Implants / Q000009:adverse effects*; D005902:Glaucoma, Open-Angle / Q000601:surgery; D006801:Humans; D008297:Male; D012086:Reoperation; D014110:Touch; D014792:Visual Acuity / Q000502:physiology