title: New continuous air pumping technique to improve clinical outcomes of descemet-stripping automated endothelial keratoplasty in asian patients with previous ahmed glaucoma valve implantation.
abstract: BACKGROUND
  To evaluate the outcomes of Descemet-stripping automated endothelial keratoplasty (DSAEK) with the use of continuous air pumping technique in Asian eyes with previous Ahmed glaucoma valve implantation.
  
  
  METHODS
  The DSAEK procedure was modified in that complete air retention of the anterior chamber was maintained for 10 min using continuous air pumping at 30 mm Hg. The primary outcome measurement was graft survival, and postoperative clinical features including, rate of graft detachment, endothelial cell count, intraocular pressure (IOP), surgical time and cup/disc ratio were also recorded.
  
  
  RESULTS
  A total of 13 eyes of 13 patients which underwent modified DSAEK and 6 eyes of 6 patients which underwent conventional DSAEK were included. There was a significant difference in graft survival curves between two groups (P = 0.029); the 1-year graft survival rates were estimated as 100% and 66.7% for patients with modified DSAEK and those with traditional DSAEK, respectively. The rate of graft detachment were 0% and 33.3% for the modified DSAEK and conventional DSAEK groups, respectively (P = 0.088). The significantly lowered surgical time for air tamponade was noted in the modified DSAEK group compared to that in the conventional DSAEK group [median (IQR): 10.0 (10.0, 10.0) min vs. 24.5 (22.0, 27.0) min; P<0.001] Postoperatively, patients in the modified DSAEK group had significantly lower IOP as compared to the conventional DSAEK group [12.0 (11.0, 15.0) mm Hg vs. 16.0 (15.0, 18.0) mm Hg; P = 0.047]. Modified DSAEK patients had higher endothelial cell counts as compared to conventional DSAEK patients [2148.0 (1964.0, 2218.0) vs. 1529.0 (713.0, 2014.0)], but the difference did not reach statistical significance (P = 0.072).
  
  
  CONCLUSIONS
  New continuous air pumping technique in DSAEK can be performed safely and effectively in patients with prior GDDs placement who have corneal failure.
authors: Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors: Chang-Min
authors: CM
authors: Liang
authors: Yi-Hao
authors: YH
authors: Chen
authors: Da-Wen
authors: DW
authors: Lu
authors: Jiann-Torng
authors: JT
authors: Chen
authors: Ming-Cheng
authors: MC
authors: Tai
mesh_terms: D000368:Aged; D000399:Air Pressure; D044466:Asian People; D003315:Cornea / Q000276:immunology / Q000601:surgery; D057111:Descemet Stripping Endothelial Keratoplasty / Q000379:methods*; D005260:Female; D005901:Glaucoma / Q000503:physiopathology / Q000601:surgery*; D020327:Glaucoma Drainage Implants; D006085:Graft Survival; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
references: Ophthalmology. 2012 Oct;119(10):1982-7
references: 22705345
references: Am J Ophthalmol. 2012 May;153(5):949-957.e1
references: 22265142
references: Cornea. 2011 Dec;30(12):1414-8
references: 21993457
references: Curr Opin Ophthalmol. 2010 Mar;21(2):144-9
references: 20040871
references: Cornea. 2012 Feb;31(2):172-5
references: 22146552
references: Am J Ophthalmol. 1999 Aug;128(2):198-204
references: 10458176
references: Ophthalmology. 2012 Mar;119(3):536-40
references: 22218143
references: Ophthalmology. 2011 Dec;118(12):2368-73
references: 21872938
references: J Glaucoma. 2008 Aug;17(5):350-5
references: 18703943
references: J Glaucoma. 2010 Mar;19(3):219-20
references: 19661823
references: Am J Ophthalmol. 2012 Jun;153(6):1091-8.e2
references: 22397954
references: Ophthalmology. 2013 Feb;120(2):246-51
references: 23107581
references: J Cataract Refract Surg. 2010 Oct;36(10):1758-62
references: 20691566
references: J Ophthalmic Vis Res. 2010 Jul;5(3):205-10
references: 22737359
references: Ophthalmology. 2011 Feb;118(2):310-4
references: 20869118
references: Ophthalmology. 2012 Jun;119(6):1130-3
references: 22385970
references: Am J Ophthalmol. 2011 Jul;152(1):48-54.e2
references: 21570672
references: Ophthalmology. 2012 Jun;119(6):1126-9
references: 22364863
references: Cornea. 2009 Sep;28(8):871-6
references: 19654530
references: Clin Ophthalmol. 2012;6:537-44
references: 22536049
references: Ophthalmology. 1998 Oct;105(10):1968-76
references: 9787371
references: Open Ophthalmol J. 2009 Jan 09;3:1-2
references: 19554220
references: Cornea. 2010 May;29(5):534-40
references: 20299975
references: Cornea. 2012 Oct;31(10):1148-53
references: 22357384
references: Cornea. 2009 Oct;28(9):959-62
references: 19724221