title: Five-year outcomes of eyes with glaucoma drainage device and penetrating keratoplasty.
abstract: OBJECTIVE
  To investigate intraocular pressure (IOP) control and corneal graft survival rates in eyes with glaucoma drainage device (GDD) implantation and penetrating keratoplasty (PK) and 5 years of follow-up data.
  
  
  METHODS
  Retrospective review.
  
  
  METHODS
  We performed a review of records of all patients who underwent both GDD placement and PK at our institution between January 1, 1988 and December 31, 2003. Twenty-eight eyes of 27 patients were studied. Glaucoma outcome was assessed by postoperative IOP, number of glaucoma medications, and need for further glaucoma surgery. Corneal grafts were assessed for clarity.
  
  
  RESULTS
  All eyes had GDD placement in the anterior chamber. The mean pre-GDD IOP was 28.8 ± 10.3 mm Hg on a mean of 2.6 ± 0.8 glaucoma medications. At 5-year follow-up, the mean IOP was 13.0 ± 5.9 mm Hg on a mean of 0.9 ± 1.0 glaucoma medications. GDD implantation successfully controlled glaucoma in 96%, 86%, 79%, 75%, and 71% of eyes at 1, 2, 3, 4, and 5 years, respectively. Grafts remained clear in 96%, 82%, 75%, 57%, and 54% of eyes at 1, 2, 3, 4, and 5 years, respectively. Failure of glaucoma outcome or graft survival was associated with prior intraocular surgeries.
  
  
  CONCLUSIONS
  Our data suggests that GDD placement can provide glaucoma control in a high percentage (71%) of eyes with PK even at 5 years. Furthermore, the success of PK in eyes with GDD remains reasonable (54%) at 5 years. IOP control and graft survival rates are comparable with earlier published studies with shorter follow-up or tube placement in the vitreous cavity.
authors: Department of Ophthalmology, University of Florida College of Medicine, Gainesville, FL 32610, USA. rknape@ufl.edu
authors: Robert M
authors: RM
authors: Knape
authors: Tiffany N
authors: TN
authors: Szymarek
authors: Sonal S
authors: SS
authors: Tuli
authors: William T
authors: WT
authors: Driebe
authors: Mark B
authors: MB
authors: Sherwood
authors: Mary Fran
authors: MF
authors: Smith
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