title: Double use of corneal graft for Descemet stripping automated endothelial keratoplasty and coverage of glaucoma drainage device tube.
abstract: OBJECTIVE
  To describe the efficacy and safety of using a single corneal graft for 2 different ocular surgeries, Descemet stripping automated endothelial keratoplasty in one patient and coverage of a glaucoma drainage device tube in another patient.
  
  
  METHODS
  The records of 12 consecutive patients who underwent Ahmed glaucoma valve implantation using the anterior lamella of a donor cornea that had been previously used for Descemet stripping automated endothelial keratoplasty were reviewed.
  
  
  RESULTS
  Nine eyes (75%) had superotemporal Ahmed valve implantation and 3 eyes (25%) had inferotemporal implantation. No intraoperative complications were encountered in any of these cases. During postoperative follow-up there were no graft rejections, wound dehiscences, tube exposures, or any glaucoma drainage device-related complications. In 1 patient, graft thinning was noticed 12 months after surgery, but without erosion of the conjunctiva or exposure of the tube. Mean intraocular pressure (IOP) before surgery was 32.8±9.3 mm Hg. The mean postoperative IOPs were 13.2±6.8 mm Hg (P<0.001) at day 1, 10.5±2.7 (P<0.001) at week 1, 12.2±3.5 (P<0.001) at month 1, 12.9±3.0 (P<0.001) at month 3, 14.2±7.0 (P<0.001) at month 6, and 13.0±6.4 (P<0.001) at the final visit. The mean reduction in IOP was 59%. Mean follow-up time after surgery was 21.7±7.5 months.
  
  
  CONCLUSIONS
  The use of the anterior corneal graft cap for patching a tube is safe and effective. The double use of a corneal graft is economically worthwhile and especially useful in countries where there is shortage of donor corneal tissues.
authors.affiliation: Department of Ophthalmology, Tel Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel. oriels1@yahoo.com
authors.forename: Oriel
authors.initials: O
authors.lastname: Spierer
authors.forename: Rony
authors.initials: R
authors.lastname: Rachmiel
authors.forename: Moshe
authors.initials: M
authors.lastname: Lazar
authors.forename: Maya
authors.initials: M
authors.lastname: Alba
authors.forename: David
authors.initials: D
authors.lastname: Varssano
mesh_terms: D003315:Cornea / Q000601:surgery; D055954:Corneal Endothelial Cell Loss / Q000601:surgery*; D016039:Corneal Transplantation; D057111:Descemet Stripping Endothelial Keratoplasty; D005901:Glaucoma / Q000601:surgery*; D020327:Glaucoma Drainage Implants; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D009926:Organ Preservation; D013048:Specimen Handling; D013524:Surgical Flaps; D014019:Tissue Donors; D014065:Tonometry, Ocular